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Individual

DR. MEL COLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1111 W FRANK AVE STE 301, LUFKIN, TX 75904-3392
(936) 639-1740
Mailing address
PO BOX 150820, LUFKIN, TX 75915-0820

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G3239
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010017879
RR MEDICARE
05
089653202
TX
01
752162824
TAX ID
Enumeration date
08/16/2006
Last updated
03/04/2016
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