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East Texas Nephrology Association
Specialist in Tyler, Texas
NPI 1497860449

East Texas Nephrology Association is a Specialist based in Tyler, TX. East Texas Nephrology Association practices in Tyler, TX. The NPI Number for East Texas Nephrology Association is 1497860449 and holds a License No. H9769 (Texas).

The current practice location address for East Texas Nephrology Association is 700 S Fleishel Ave, Tyler, TX and can be reached out via phone at 903-526-6374 and via fax at 903-526-4578.

Location: 700 S Fleishel Ave, Tyler, TX, 75701-2014
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1497860449
Provider Name
East Texas Nephrology Association
Credential
Provider Entity Type
Organization
Address
700 S Fleishel Ave, Tyler, TX, 75701-2014
Phone Number
903-526-6374
Fax Number
903-526-4578
Provider Enumeration Date
08/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0086HD 01 TX BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
700 S Fleishel Ave
City
Tyler
State
Texas
Zip
75701-2014
Phone Number
903-526-6374
Fax Number
903-526-4578
person
Provider Business Mailing Address Details
Address
700 S Fleishel Ave
City
Tyler
State
Texas
Zip
75701-2014
Phone Number
903-526-6374
Fax Number
903-526-4578
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
H9769 (Texas)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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