| Dehaven Surgical Center, Inc | |
|
1424 East Front Tyler TX 75702-8501 | |
| (903) 595-7510 | |
| (903) 526-5491 |
| Full Name | Dehaven Surgical Center, Inc |
|---|---|
| Speciality | Clinic/center - Ambulatory Surgical |
| Location | 1424 East Front, Tyler, Texas |
| Authorized Official Name and Position | Gina V. Lowndes (FINANCIAL SERVICE MANAGER) |
| Authorized Official Contact | 9035957510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dehaven Surgical Center, Inc Po Box 130639 Tyler TX 75713-0639 Ph: (903) 595-7510 | Dehaven Surgical Center, Inc 1424 East Front Tyler TX 75702-8501 Ph: (903) 595-7510 |
| NPI Number | 1376540096 |
|---|---|
| Provider Enumeration Date | 07/07/2005 |
| Last Update Date | 03/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376540096 | NPI | - | NPPES |
| 085855701 | Medicaid | TX | |
| HH1281 | Other | TX | BLUE CROSS BLUE SHIELD |
| 7170358 | Other | TX | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 000228 (Texas) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | 000228 (Texas) | Primary |
Pure Radiance Laser Retreat Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6722 S Broadway Ave, Tyler, TX 75703 Phone: 903-561-0300 | |
Clifford D. Mullins, D.c., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14653 Eastside Rd, Tyler, TX 75707 Phone: 903-566-4449 | |
Frank P Reuter Jr Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 712 S Bois D Arc Ave, Tyler, TX 75701 Phone: 903-597-5579 Fax: 903-597-5722 | |
David W Ball Md Internal Medicine Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5407 New Copeland Rd Ste 200, Tyler, TX 75703 Phone: 903-330-2081 Fax: 903-630-9309 | |
Integrity Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5605 Old Bullard Rd Ste B, Tyler, TX 75703 Phone: 903-630-5595 Fax: 903-630-5599 | |
Clinica Hispana Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 510 S Southwest Loop 323 Ste 140, Tyler, TX 75702 Phone: 903-530-0240 | |
Bwbl Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6770 Old Jacksonville Hwy Ste 101, Tyler, TX 75703 Phone: 903-352-3250 Fax: 903-221-9183 |