Provider Demographics
NPI:1700844867
Name:SATIR AND SATIR, PA
Entity Type:Organization
Organization Name:SATIR AND SATIR, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:COGBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-560-9595
Mailing Address - Street 1:PO BOX 631940
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75963-1940
Mailing Address - Country:US
Mailing Address - Phone:936-560-9595
Mailing Address - Fax:936-462-7772
Practice Address - Street 1:4942 NE STALLINGS DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1265
Practice Address - Country:US
Practice Address - Phone:936-560-9595
Practice Address - Fax:936-462-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153214501Medicaid
TX153214501Medicaid