East Texas Urology, Pllc

NPI #1154400265 in Longview, Texas

Provider Information

NPI Number: 1154400265
Entity Type: Organization
Organization Name: East Texas Urology, Pllc
Primary Specialty: Specialist
Enumeration Date: Nov 2, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 703 E MARSHALL AVE
Address 2: SUITE 5008
City: Longview
State: Texas
ZIP Code: 75601-5500
Phone: (903) 757-7871

Authorized Official

Name: MRS. VICKI ANN CARRINGTON
Title: OFFICE MANAGER
Phone: (903) 757-7871

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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