East Texas Treatment Center

NPI #1023002425 in Kilgore, Texas

Provider Information

NPI Number: 1023002425
Entity Type: Organization
Organization Name: East Texas Treatment Center
Primary Specialty: Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Enumeration Date: Aug 31, 2005
Last Updated: Feb 17, 2022

Practice Location

Address: 1200 DUDLEY RD
City: Kilgore
State: Texas
ZIP Code: 75662-3306
Phone: (903) 984-5571

Authorized Official

Name: TERRY HARDAN
Title: EXECUTIVE DIRECTOR
Phone: (903) 984-5571

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X
Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) — Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	261QR0401X	Primary

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