KOVIC SHANE BAILEY

TYLER, TX
NPI1194467688
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: TX  BP10080618)
Enumeration Date2022-04-13
Last Update Date2022-04-13
Business Address
KOVIC SHANE BAILEY DO
11937 US HIGHWAY 271
TYLER, TX 75708-3154
Phone number: 903-877-7777
Mailing Address
KOVIC SHANE BAILEY DO
11937 US HIGHWAY 271
TYLER, TX 75708-3154
Phone number: 903-877-7777