EAST TEXAS FAMILY SUPPORT CLINIC NPI 1699315499

NPI Information

NPI: 1699315499
Provider Name: EAST TEXAS FAMILY SUPPORT CLINIC
Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

Address:
1305 DOCTORS DR
TYLER, TX
ZIP 75701
Phone: (903) 525-9397
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EAST TEXAS FAMILY SUPPORT CLINIC is a pain clinic center in Tyler, TX. EAST TEXAS FAMILY SUPPORT CLINIC NPI is 1699315499. The provider is registered as an organization entity type.

The provider's business location address is:

1305 DOCTORS DR
TYLER, TX
ZIP 75701-263
Phone: (903) 525-9397
Fax: (903) 525-9398

The provider's authorized official is Jennifer A Blake .
The authorized official title is Owner and has the following contact phone number (954) 557-2775.

The enumeration date for this NPI number is 1/9/2020 and was last updated on 6/11/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	No
2	261QM2500X	Clinic/Center	Medical Specialty	No
3	261QP3300X	Clinic/Center	Pain	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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