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Jeremiah Revada
Student in an Organized Health Care Education/Training Program in Tyler, Texas
NPI 1659855864

Jeremiah Revada is a Student in an Organized Health Care Education/Training Program based in Tomball, TX. Jeremiah Revada practices in Tyler, TX. The NPI Number for Jeremiah Revada is 1659855864 and holds a License No. (Texas).

The current practice location address for Jeremiah Revada is 3900 University Blvd, Tyler, TX and can be reached out via phone at 903-566-7000.

Location: 3900 University Blvd, Tyler, TX, 77375-7599
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659855864
Provider Name
Jeremiah Revada
Credential
Provider Entity Type
Individual
Gender
Male
Address
3900 University Blvd, Tyler, TX, 77375-7599
Phone Number
903-566-7000
Fax Number
Provider Enumeration Date
09/24/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3900 University Blvd
City
Tyler
State
Texas
Zip
75799-6600
Phone Number
903-566-7000
Fax Number
person
Provider Business Mailing Address Details
Address
3900 University Blvd
City
Tyler
State
Texas
Zip
75799-6600
Phone Number
903-566-7000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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