Organization
RED OAK EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH GATEWOOD (AUTHORIZED SIGNER)
(800) 355-0808
Entity
Organization
Contact information
Practice address
2500 E MAIN ST, ALICE, TX 78332-4169
(361) 661-8000
(361) 668-2251
Mailing address
PO BOX 41645, PHILADELPHIA, PA 19101
(800) 444-7009
(800) 305-3233
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0075KD
BLUE SHIELD
TX
01
—
A001
CHAMPUS/TRICARE
TX
Enumeration date
06/04/2008
Last updated
06/04/2008
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