University Of Texas Health Science Center At Tyler-facilty-physician | |
102 W Henderson St Overton TX 75684-1613 | |
(903) 834-0201 | |
(903) 834-0264 |
Full Name | University Of Texas Health Science Center At Tyler-facilty-physician |
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Speciality | Clinic/center - Rural Health |
Location | 102 W Henderson St, Overton, Texas |
Authorized Official Name and Position | Daniel Deslatte (CHIEF BUSINESS OFFICER) |
Authorized Official Contact | 9038777200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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University Of Texas Health Science Center At Tyler-facilty-physician 11937 Us Highway 271 Tyler TX 75708-3154 Ph: (903) 877-7200 | University Of Texas Health Science Center At Tyler-facilty-physician 102 W Henderson St Overton TX 75684-1613 Ph: (903) 834-0201 |
NPI Number | 1689496812 |
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Provider Enumeration Date | 10/29/2024 |
Last Update Date | 10/29/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689496812 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |