Organization · Type 2 NPI

East Texas Out-Patient PLLC

Family Medicine Physician · Edgewood, TX

NPI number 1417511593 Active

Practice location

116 N Houston St
Edgewood, TX 75117-1555

Fax (903) 385-3340

Mailing address

PO Box 76
Canton, TX 75103-0076

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician Primary 207Q00000XNone listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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About NPI 1417511593

East Texas Out-Patient PLLC's National Provider Identifier is 1417511593, issued on Apr 24, 2019. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Edgewood, TX. The record was last updated on Jul 1, 2025.