East Lake Medical, Pllc
NPI #1497494777 in Tyler, Texas
Provider Information
- NPI Number
- 1497494777
- Entity Type
- Organization
- Organization Name
- East Lake Medical, Pllc
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- Jun 3, 2022
- Last Updated
- Jun 3, 2022
Practice Location
Authorized Official
- Name
- JENA DECANTER, NP
- Title
- NURSE PRACTITIONER
- Phone
- (903) 650-8619
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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