Organization
PINEY WOODS ER III LLC
Active
Other names
EXCEL ER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER KWON M.D. (MANAGER)
(903) 792-0911
Entity
Organization
Contact information
Practice address
4102 GIBSON LANE, TEXARKANA, TX 75503
(903) 792-0911
Mailing address
4102 GIBSON LANE, TEXARKANA, TX 75503
(903) 792-0911
(903) 792-0353
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160258
DEPARTMENT OF STATE HEALTH SERVICES
TX
Enumeration date
08/03/2015
Last updated
09/01/2016
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