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NPI Code Detail

MEDICARE: EAST TEXAS FAMILY MEDICINE PA

MEDICARE: EAST TEXAS FAMILY MEDICINE PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CS1114OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205974417
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAST TEXAS FAMILY MEDICINE PA
Provider Business Mailing Address
First Line : 4201 S LOOP 256
Second Line :
City : PALESTINE
State : TX
Zip : 75801-8476
Country : US
Telephone Number : 903-723-8533
Fax Number : 903-723-5190
Provider Business Practice Location Address
First Line : 4201 S LOOP 256
Second Line :
City : PALESTINE
State : TX
Zip : 75801-8476
Country : US
Telephone Number : 903-723-8533
Fax Number : 903-723-5190
Authorized Official
Title or Position : PRACTICE MGR
Name : DANNY R ALLISON
Credential :
Telephone Number : 903-723-8533
Provider Enumeration Date : 02/01/2007
Last Update Date : 05/20/2008

Similar Medicare Providers

1184370595 — ALICIA DANIELLE WILMETH FNP-BC
Practice Location Address:
4201 S LOOP 256
PALESTINE, TX
75801-8476
Practice Phone: 903-723-8533
Practice Fax:
1902827801 — DR. SIDNEY BOYD CHADWELL JR. D.O.
Practice Location Address:
4201 S LOOP 256
PALESTINE, TX
75801-8476
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Practice Fax: 903-723-5190
1528071172 — JOHN KLEIN MD
Practice Location Address:
4201 S LOOP 256
PALESTINE, TX
75801-8476
Practice Phone: 903-723-8533
Practice Fax:
1861405417 — DELANEY DEAN FRENCH MD
Practice Location Address:
4201 S LOOP 256
PALESTINE, TX
75801-8476
Practice Phone: 903-723-8533
Practice Fax:
1487667036 — ALLEN FORBES MILLS MD
Practice Location Address:
4201 S LOOP 256
PALESTINE, TX
75801-8476
Practice Phone: 903-723-8533
Practice Fax:
1063239556 — LESLIE STEADMAN MSN, APRN, FNP-C
Practice Location Address:
4201 S LOOP 256
PALESTINE, TX
75801-8476
Practice Phone: 903-723-8533
Practice Fax:

Directions to “EAST TEXAS FAMILY MEDICINE PA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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