Theresa M Vail Md Pa | |
606 S Fleishel Ave Tyler TX 75701-2012 | |
(903) 595-5500 | |
(903) 595-5506 |
Full Name | Theresa M Vail Md Pa |
---|---|
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 606 S Fleishel Ave, Tyler, Texas |
Authorized Official Name and Position | Theresa Marie Vail (OWNER) |
Authorized Official Contact | 9035955500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Theresa M Vail Md Pa 606 S Fleishel Ave Tyler TX 75701-2012 Ph: (903) 595-5500 | Theresa M Vail Md Pa 606 S Fleishel Ave Tyler TX 75701-2012 Ph: (903) 595-5500 |
NPI Number | 1639267750 |
---|---|
Provider Enumeration Date | 10/11/2006 |
Last Update Date | 11/20/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639267750 | NPI | - | NPPES |
0076PW | Other | TX | BCBS |
P00039903 | Other | TX | RAILROAD MEDICARE |
168653701 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | L0672 (Texas) | Primary |
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