Organization
FOUR STATES EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH GATEWOOD MD (PRESIDENT)
(214) 712-2000
Entity
Organization
Contact information
Practice address
1000 PINE ST, TEXARKANA, TX 75501-5100
(903) 798-8887
Mailing address
1717 MAIN ST, SUITE 5200, DALLAS, TX 75201-4605
(214) 712-2000
(214) 712-2487
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0080NL
BCBS
TX
01
—
8P191
BLUE SHIELD
AR
Enumeration date
05/18/2006
Last updated
04/20/2008
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