| Organization Name: | EAST TEXAS FAMILY HEALTHCARE PLLC |
| NPI Number: | 1629087630 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KALYAN K RATH (OWNER) |
| Mailing Address: | 1905 N Margaret Ave Kirbyville |
| State: | TX US |
| Postal Code: | 759561652 |
| Phone Number: | 4094200816 |
| Fax Number: | 4094200821 |
| NPI Enumeration Date: | 08/07/2006 |
| NPI Last Update Date: | 03/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 673880 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |