Organization
EAST TEXAS SUPPORT SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA JANEAUX (EXECUTIVE ADMINISTRATOR)
(409) 384-8751
Entity
Organization
Contact information
Practice address
109 W WATER ST, JASPER, TX 75951-4423
(409) 384-8751
(409) 489-0289
Mailing address
PO BOX 2440, JASPER, TX 75951-0026
(409) 384-8751
(409) 489-0289
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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