University of Texas Health Science Center at Tyler-Facilty-Physician

NPI #1689496812 in Overton, Texas

Provider Information

NPI Number: 1689496812
Entity Type: Organization
Organization Name: University of Texas Health Science Center at Tyler-Facilty-Physician
Primary Specialty: Clinic/Center - Rural Health
Enumeration Date: Oct 29, 2024
Last Updated: Dec 17, 2024

Practice Location

Address: 102 W HENDERSON ST
City: Overton
State: Texas
ZIP Code: 75684-1613
Phone: (903) 834-0201

Authorized Official

Name: DANIEL DESLATTE
Title: CHIEF BUSINESS OFFICER
Phone: (903) 877-7200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rural Health — Rural Health	261QR1300X	Primary

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