Individual
ABO MOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 E MARSHALL AVE, LONGVIEW, TX 75601-5580
(903) 315-2000
Mailing address
700 E MARSHALL AVE, LONGVIEW, TX 75601-5580
(903) 315-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10044201
TX
207RR0500X
Rheumatology Physician
Primary
55093
KY
207RR0500X
Rheumatology Physician
TP931
KY
Other
Enumeration date
07/20/2012
Last updated
04/25/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us