Organization
TOTAL WOMENS CARE OF EAST TEXAS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA WHITWORTH (BILLING SUPERVISOR)
(903) 727-0110
Entity
Organization
Contact information
Practice address
126 MEDICAL DR, SUITE B, PALESTINE, TX 75801-8506
(903) 729-4000
(903) 729-3600
Mailing address
126 MEDICAL DR, SUITE B, PALESTINE, TX 75801-8506
(903) 729-4000
(903) 729-3600
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0090TM
BC/BS OF TEXAS
TX
05
—
212117002
—
TX
Enumeration date
05/17/2010
Last updated
11/10/2011
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