| East Texas Infusion Center, Pllc | |
|
935 S Baxter Ave Tyler TX 75701-2245 | |
| (903) 592-4473 | |
| (903) 592-4474 |
| Full Name | East Texas Infusion Center, Pllc |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 935 S Baxter Ave, Tyler, Texas |
| Authorized Official Name and Position | Steven Lynn Hickreson (PRESIDENT) |
| Authorized Official Contact | 9035924473 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Texas Infusion Center, Pllc 935 S Baxter Ave Tyler TX 75701-2245 Ph: (903) 592-4473 | East Texas Infusion Center, Pllc 935 S Baxter Ave Tyler TX 75701-2245 Ph: (903) 592-4473 |
| NPI Number | 1124515879 |
|---|---|
| Provider Enumeration Date | 04/18/2018 |
| Last Update Date | 04/18/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124515879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
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