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General NPI Number Information
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NPI Number | 1164394417
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Entity Type | Organization
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Legal Business Name | EAST TEXAS CENTER FOR METABOLIC WELLNESS LLC
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 1220 NORTH ST STE 100
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City | NACOGDOCHES
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State | TX
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Zip | 75961-4010
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Country | US
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Telephone | 936-244-8114
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 COUNTY ROAD 331
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City | NACOGDOCHES
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State | TX
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Zip | 75961-0401
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Country | US
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Telephone | 214-680-6993
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARTY GILLIAM FRENCH
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Credential | NONE
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Telephone | 214-680-6993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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