Organization
E REMENCHIK MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLEN JEAN REMENCHIK M.D. (SOLE MEMBER)
(903) 553-0353
Entity
Organization
Contact information
Practice address
717 N 4TH ST, SUITE 3, LONGVIEW, TX 75601-5438
(903) 758-0020
(903) 758-0067
Mailing address
717 N 4TH ST, SUITE 3, LONGVIEW, TX 75601-5438
(903) 758-0020
(903) 758-0067
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G8366
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218907801
—
TX
Enumeration date
09/13/2010
Last updated
01/17/2012
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