EAST TEXAS FAMILY SUPPORT CLINIC (NPI# 1699315499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1699315499 |
Entity Type | Organization |
Organization Name | EAST TEXAS FAMILY SUPPORT CLINIC |
Practice Address |
1305 Doctors Dr Tyler TX 75701-2263 |
Practice Telephone | 9035259397 |
Practice Fax Number | 9035259398 |
Mailing Telephone | 9035259397 |
Mailing Fax Number | 9035259398 |
Enumeration Date | 2020-01-09 |
Last Update Date | 2020-06-11 |
Authorized Official Name | JENNIFER A BLAKE (OWNER) |
Authorized Official Telephone | 9545572775 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities | ||
Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
Street Address |
1305 DOCTORS DR |
City | TYLER |
State | TX |
Zip Code | 75701-2263 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396350039 | Lorna Casey Blakney | Nurse Practitioner | 1305 Doctors Dr, Tyler, TX 75701-2263 | 2020-09-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
Find all providers in zip 75701 |
Taxonomy Code | 261QP3300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Pain |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659987576 | Greater Houston Pain & Injury, Inc | Clinic/Center | 4411 Bluebonnet Dr Ste 100, Stafford, TX 77477-2912 | 2020-09-16 |
1538706718 | Consultants In Pain Medicine, Pa | Clinic/Center | 332 W Sunset Rd Ste 3, San Antonio, TX 78209-1755 | 2019-12-05 |
1982249405 | Ikon Pain Management Consultants Pllc | Clinic/Center | 8300 Douglas Ave Ste 800, Dallas, TX 75225-5826 | 2019-11-07 |
1700443298 | Synapse Pain Management, Pllc | Clinic/Center | 6760 Pistoia Dr, Frisco, TX 75034-2381 | 2019-05-21 |
1306302062 | Quicksilver Billing | Clinic/Center | 14215 Marin Dr, Cypress, TX 77429-4962 | 2019-02-18 |
1518458215 | Centers for Pain Relief Pllc | Clinic/Center | 2416 W Holcombe Blvd Ste A, Houston, TX 77030-1902 | 2018-05-29 |
1942797527 | Mansfield Pain Services, LLC | Clinic/Center | 305 Regency Pkwy Ste 805, Mansfield, TX 76063-3794 | 2018-04-18 |
1427554880 | Pain Institute of Laredo | Clinic/Center | 5401 Mcpherson Rd Ste 9, Laredo, TX 78041 | 2018-04-04 |
1588165344 | Revolution Pain Management, Pllc | Clinic/Center | 1485 Fm 1960 Bypass Rd E Ste 360, Humble, TX 77338-3964 | 2018-02-26 |
1427562891 | Midcounty Pain Services, LLC | Clinic/Center | 2501 Jimmy Johnson Blvd Ste 201b, Port Arthur, TX 77640-2009 | 2017-11-21 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on EAST TEXAS FAMILY SUPPORT CLINIC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.