Organization
EAST TEXAS MEDICAL CENTER CROCKETT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACY BAILEY DISE (BUSINESS OFFICE DIRECTOR)
(936) 546-3810
Entity
Organization
Contact information
Practice address
1100 E LOOP 304, CROCKETT, TX 75835-1810
(936) 546-3862
(936) 546-3816
Mailing address
PO BOX 1129, CROCKETT, TX 75835-1129
(936) 546-3849
(936) 546-3816
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/13/2006
Last updated
08/22/2020
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