Provider Demographics
NPI:1205104270
Name:EAST TEXAS CARETEAM, INC
Entity type:Organization
Organization Name:EAST TEXAS CARETEAM, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-663-2331
Mailing Address - Street 1:4362 US HIGHWAY 259 N
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-7674
Mailing Address - Country:US
Mailing Address - Phone:903-663-2331
Mailing Address - Fax:903-663-4847
Practice Address - Street 1:4362 US HIGHWAY 259 N
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-7674
Practice Address - Country:US
Practice Address - Phone:903-663-2331
Practice Address - Fax:903-663-4847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013060251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health