Organization
EAST TEXAS MINIMALLY INVA MICRO NS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ESTHER M TIVIDAD R.N. (OFFICE MANAGER)
(903) 238-8110
Entity
Organization
Contact information
Practice address
703 E MARSHALL AVE, SUITE 3004, LONGVIEW, TX 75601-5500
(903) 238-8110
(903) 238-8190
Mailing address
703 E MARSHALL AVE, SUITE 3004, LONGVIEW, TX 75601-5500
(903) 238-8110
(903) 238-8190
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
10/18/2007
Last updated
07/19/2011
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