Organization Name: | EAST TEXAS PHYSICIANS ALLIANCE,LLP |
NPI Number: | 1235387424 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALEC B LAW (MANAGING PARTNER) |
Mailing Address: | 3201 S Loop 256 Palestine |
State: | TX US |
Postal Code: | 758016901 |
Phone Number: | 9036617173 |
Fax Number: | 9036617182 |
NPI Enumeration Date: | 09/03/2008 |
NPI Last Update Date: | 10/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 662200000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |