Organization
LONGVIEW EMERGENCY MEDICINE ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STANLEY D UPCHURCH MD (PRESIDENT)
(903) 927-6000
Entity
Organization
Contact information
Practice address
811 S WASHINGTON AVE, MARSHALL, TX 75670-5336
(903) 927-6000
Mailing address
PO BOX 24006, FORT WORTH, TX 76124-1006
(817) 451-4208
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0055PM
BLUE CROSS BLUE SHIELD
TX
Enumeration date
03/15/2007
Last updated
02/04/2008
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