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General NPI Number Information
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NPI Number | 1972512986
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Entity Type | Organization
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Legal Business Name | EAST TEXAS FAMILY HEALTHCARE PLLC
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 1304 W COURT ST
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City | NEWTON
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State | TX
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Zip | 75966-3009
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Country | US
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Telephone | 409-379-2177
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Fax | 409-379-2188
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Provider Business Mailing Address
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Address Line | 1304 W COURT ST
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City | NEWTON
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State | TX
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Zip | 75966-3009
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Country | US
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Telephone | 409-379-2177
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Fax | 409-379-2188
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Authorized Official
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Title or Position | OWNER
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Name | KALYAN K RATH
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Credential | MD
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Telephone | 409-384-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 673865
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License Number State | TX
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