East Texas Women'S Clinic

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

F1548 Issued in TX

Legal business name

EAST TEXAS WOMEN'S CLINIC

Practice address

401 Gaslight Blvd
Lufkin, TX 75904-3132

Phone

(936) 639-4417

NPI assigned

Dec 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Donna Kay Grimes

Title

Office Manager

Phone

(936) 639-4463

Specialties & licenses 1

Addresses

Other names 1

• CHARLES L FOUGEROUSSE MD Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1942484712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043132",
            "telephone_number": "936-639-4463",
            "fax_number": "936-639-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043132",
            "telephone_number": "936-639-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS WOMEN'S CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "936-639-4463",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "F1548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHARLES L FOUGEROUSSE MD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• East Texas Internal Medicine PA
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• East Texas Premier Pediatrics PLLC
• East Texas Therapy Centers, LLC
• Michael Eddins, FNP-C
• Julieta Banda Edmond, MA
• Laura Edmundson, PHARMD
• Educare Community Living Limited Partnership
• Educare Community Living Limited Partnership

• Obstetrics & Gynecology Physician in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.