RANDY L. MORTON, M.D., PLLC
Radiology at 4 St, Longview, TX

License number
Texas G5407
Category
Radiology
Type
Surgery
Owner
Name: DR. RANDY LOREN MORTON M.D.
Title: OWNER
Phone: (903) 753-7205
Address
Address
3209 N 4Th St SUITE 300, Longview, TX 75605
National Provider ID: 1922311190
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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RANDY L. MORTON M.D., PLLC

3209 4 St, Longview, TX 75605

Registration:
Dec 27, 2009
State ID:
0801209579
Business type:
Domestic Limited Liability Company (LLC)
President:
Randy L Morton (President), 1330 Thyme Rd, Diana, TX 75640
Agent:
Randy L. Morton,3209 N 4 St, Longview, TX 75601 (Physical)
TIN:
32040898606

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