| Rose City Neurology | |
|
1312 Doctors Dr Tyler TX 75701-2262 | |
| (903) 526-4350 | |
| (800) 580-1493 |
| Full Name | Rose City Neurology |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1312 Doctors Dr, Tyler, Texas |
| Authorized Official Name and Position | Wayne E Hostetler (OWNER) |
| Authorized Official Contact | 9035264350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rose City Neurology 1312 Doctors Dr Tyler TX 75701-2262 Ph: (903) 526-4350 | Rose City Neurology 1312 Doctors Dr Tyler TX 75701-2262 Ph: (903) 526-4350 |
| NPI Number | 1265615439 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 09/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265615439 | NPI | - | NPPES |
| 163702701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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