Provider Demographics
NPI:1700263621
Name:NORTHEAST TEXAS SURGICAL SPECIALISTS PLLC
Entity Type:Organization
Organization Name:NORTHEAST TEXAS SURGICAL SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGGORY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ANGIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-577-0784
Mailing Address - Street 1:P.O. BOX 15584
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4050
Mailing Address - Country:US
Mailing Address - Phone:903-577-0784
Mailing Address - Fax:903-577-8984
Practice Address - Street 1:2001 N JEFFERSON AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2338
Practice Address - Country:US
Practice Address - Phone:903-577-0784
Practice Address - Fax:903-577-8984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty