Organization
EAST TEXAS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON STALNAKER (EXECUTIVE DIRECTOR)
(903) 759-4966
Entity
Organization
Contact information
Practice address
201 PINE TREE RD, LONGVIEW, TX 75604-4140
(903) 759-4966
Mailing address
PO BOX 9486, LONGVIEW, TX 75608-9486
(903) 759-4966
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
02/11/2022
Last updated
04/11/2022
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