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2101 W Loop 281 Longview TX 75604-2506 | |
(903) 759-7200 | |
(903) 759-7206 |
Full Name | |
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Speciality | Family Medicine |
Location | 2101 W Loop 281, Longview, Texas |
Authorized Official Name and Position | John Ford (ADMINISTRATOR) |
Authorized Official Contact | 9032470484 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4002 Technology Ctr Longview TX 75605-2697 Ph: (903) 247-0484 | 2101 W Loop 281 Longview TX 75604-2506 Ph: (903) 759-7200 |
NPI Number | 1447308903 |
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Provider Enumeration Date | 01/08/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1447308903 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (Texas) | Primary |
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