Organization
KRISTI B BAGNELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BAGNELL (MANAGER)
(305) 587-9062
Entity
Organization
Contact information
Practice address
2304 JUDSON RD STE D, LONGVIEW, TX 75605-4675
(903) 212-6060
Mailing address
2304 JUDSON RD STE D, LONGVIEW, TX 75605-4675
(903) 212-6060
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
03/23/2018
Last updated
03/23/2018
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