| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 10/29/2024 |
| Last Update Date | 12/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689496812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |