Organization
EAST TEXAS WOMEN'S CLINIC
Active
Other names
CHARLES L FOUGEROUSSE MD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA KAY GRIMES (OFFICE MANAGER)
(936) 639-4463
Entity
Organization
Contact information
Practice address
401 GASLIGHT BLVD, LUFKIN, TX 75904-3132
(936) 639-4417
Mailing address
401 GASLIGHT BLVD, LUFKIN, TX 75904-3132
(936) 639-4463
(936) 639-4417
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
F1548
TX
Other
Enumeration date
12/28/2007
Last updated
12/28/2007
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