Organization
GEORGE L. DELOACH, D.O., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE L DELOACH D.O. (PHYSICIAN/PRESIDENT)
(936) 755-3238
Entity
Organization
Contact information
Practice address
403 OGLETREE DR STE 100, LIVINGSTON, TX 77351-9444
(936) 327-9222
(936) 755-3249
Mailing address
PO BOX 337, LIVINGSTON, TX 77351-0006
(936) 327-9222
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
H9881
TX
332B00000X
Durable Medical Equipment & Medical Supplies
4934240001
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0048QS
BLUE CROSS BLUE SHEILD
TX
05
—
154512101
—
TX
01
—
DG4922
MEDICARE RR/PALMETTO GBA
—
Enumeration date
08/28/2007
Last updated
03/01/2024
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