| Advanced Wellness | |
|
5605 Old Bullard Rd Ste B Tyler TX 75703 | |
| (903) 630-5595 | |
| (903) 630-5599 |
| Full Name | Advanced Wellness |
|---|---|
| Speciality | Internal Medicine |
| Location | 5605 Old Bullard Rd Ste B, Tyler, Texas |
| Authorized Official Name and Position | Roxanne W. Wheeler (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9365793931 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Wellness 212 Old Grande Blvd Ste A200 Tyler TX 75703-4204 Ph: (214) 327-3186 | Advanced Wellness 5605 Old Bullard Rd Ste B Tyler TX 75703 Ph: (903) 630-5595 |
| NPI Number | 1427540806 |
|---|---|
| Provider Enumeration Date | 06/01/2018 |
| Last Update Date | 09/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427540806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
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