East TX Pediatrician Opportunity Information Request

Thanks for your interest in this East Texas Pediatric opportunity . It�s truly a great Pedi Practice job, with an excellent group of pediatricians, in a beautiful Texas location.

For more East TX pediatrician opportunity information, just complete the form below. I�ll be in touch soon to answer your questions and share additional East TX Pediatrician opportunity information.

So let�s begin exploring this Pediatric opportunity and see if it encompasses all you�re looking for in a new Pedi practice.

Thanks again doctor. I look forward to providing you the "full scoop" on this great East Texas Pediatric opportunity!

Mark Pyrc
Physicians-Jobs-In-Texas.com
(888) 508-3757

East Texas Pediatrician Opportunity
Information Request

Please note that all fields followed by an asterisk must be filled in.

Title*
Title*

	M.D.
	D.O.

First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

Street Address*
Street Address*

City*
City*

State/Prov*
State/Prov*

Zip/Postal Code

Home Phone*
Home Phone*

Business Phone

Mobile Phone

Best Time & Method to Reach You*
Best Time & Method to Reach You*

Your Practice Specialty*
Your Practice Specialty*

Board Status*
Board Status*

	Board Certified
	Board Eligible
	Not Board Eligible

Type of Practice You Desire*
Type of Practice You Desire*

	Solo (Hospital Sponsored)
	Single Specialty Group
	Multi-Specialty Group
	Employed Position
	No Preference

Any special considerations that must be taken into account? (Family needs, practice specifics you require)

Citizenship Status*
Citizenship Status*

	US Citizen
	Permanent Resident
	H1B Visa
	J1 Visa

Have you had any restrictions or disciplinary action placed on your license at any time by either the DEA, State or Federal governments?*
Have you had any restrictions or disciplinary action placed on your license at any time by either the DEA, State or Federal governments?*

	Yes
	No

Have you had any Malpractice judgments or settlements in the past 5 years?*
Have you had any Malpractice judgments or settlements in the past 5 years?*

	Yes
	No

Please enter the word that you see below.

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