| St. Paul's Mobile Clinic | |
|
928 N Glenwood Blvd Tyler TX 75702-5055 | |
| (903) 533-7400 | |
| Not Available |
| Full Name | St. Paul's Mobile Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 928 N Glenwood Blvd, Tyler, Texas |
| Authorized Official Name and Position | Judy Davis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9035337404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Paul's Mobile Clinic 815 N Broadway Ave Tyler TX 75702-4507 Ph: (903) 535-0023 | St. Paul's Mobile Clinic 928 N Glenwood Blvd Tyler TX 75702-5055 Ph: (903) 533-7400 |
| NPI Number | 1265613285 |
|---|---|
| Provider Enumeration Date | 11/19/2007 |
| Last Update Date | 11/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265613285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
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