Provider Demographics
NPI:1609816438
Name:GREGG COUNTY HEALTH DEPT.
Entity Type:Organization
Organization Name:GREGG COUNTY HEALTH DEPT.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GREGG COUNTY HEALTH AUTHORITY
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWNE
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:903-237-2621
Mailing Address - Street 1:405 E MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5440
Mailing Address - Country:US
Mailing Address - Phone:903-237-2621
Mailing Address - Fax:903-237-2608
Practice Address - Street 1:405 E MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5440
Practice Address - Country:US
Practice Address - Phone:903-237-2621
Practice Address - Fax:903-237-2608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6485251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX90924839OtherTEXAS PROVIDER NUMBER