East Texas Plastic Surgery Llp

LBN: East Texas Plastic Surgery Llp
East Texas Plastic Surgery Llp is an health care organization with primary practice located at 703 E Marshall Ave Ste 4008 , Longview TX 75601-5622. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as the primary health care specialty. East Texas Plastic Surgery Llp can be contacted via phone (903) 753-2276, or through Jacobs, Gary R via phone (903) 753-2276.

Contact Information

Primary practice address
703 E Marshall Ave Ste 4008 Longview TX 75601-5622
Phone: (903) 753-2276
Fax: (903) 753-7420
Website:
Map and Directions
Authorized official contact:
Name: Jacobs, Gary R Doctor of Medicine (MD)
Phone: (903) 753-2276

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X E4427 Texas

Profile Details

NPI number 1215152251
LBN Legal business name East Texas Plastic Surgery Llp
DBA Doing business as
Authorized official Jacobs, Gary R Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 16th, 2007
Last updated Jul 18th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215152251 NPPES
Texas MEDICAID 110309502

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