Organization
PINEY WOODS ER IV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER KWON MD (CEO)
(936) 569-0911
Entity
Organization
Contact information
Practice address
1420 NORTH ST, NACOGDOCHES, TX 75961-4037
(936) 569-0911
Mailing address
1420 NORTH ST, NACOGDOCHES, TX 75961-4037
(936) 569-0911
(936) 569-9131
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160260
DEPARTMENT OF STATE HEALTH SERVICES
TX
Enumeration date
03/07/2016
Last updated
09/01/2016
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