NPI | 1750764189 |
---|---|
Former Legal Business Name | TRINA HEALTH CARE CENTER OF TYLER LLC |
Entity Type | Organization |
Authorized Contact | JEFF E DETHLEFSEN Owner 903-258-6000 |
Organization Subpart ? | No |
Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy (Licence: TX 261Q10500X) |
Additional Taxonomies | 207Q00000X Family Medicine |
207Q00000X Family Medicine (Licence: TX F3205) | |
207R00000X Internal Medicine | |
Enumeration Date | 2015-07-02 |
Last Update Date | 2022-07-21 |