East Texas Minimally Inva Micro Ns

NPI #1730378449 in Longview, Texas

Provider Information

NPI Number: 1730378449
Entity Type: Organization
Organization Name: East Texas Minimally Inva Micro Ns
Primary Specialty: Neurological Surgery
Enumeration Date: Oct 18, 2007
Last Updated: Jul 19, 2011

Practice Location

Address: 703 E MARSHALL AVE
Address 2: SUITE 3004
City: Longview
State: Texas
ZIP Code: 75601-5500
Phone: (903) 238-8110

Authorized Official

Name: MRS. ESTHER M TIVIDAD, R.N.
Title: OFFICE MANAGER
Phone: (903) 238-8110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Neurological Surgery	207T00000X	Primary

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