MPP INFUSION CENTER OF TYLER LLC (NPI# 1952812109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952812109 |
| Entity Type | Organization |
| Organization Name | MPP INFUSION CENTER OF TYLER LLC |
| Other Organization Name | MEDICAL MANAGEMENT COMPANY OF TYLER |
| Practice Address |
6115 New Copeland Rd Ste 120.130 Tyler TX 75703-6369 |
| Mailing Address |
1726 Cole Blvd Ste 250 Lakewood CO 80401-3262 |
| Practice Telephone | 9725980000 |
| Mailing Telephone | 7204655030 |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2020-06-15 |
| Authorized Official Name | MRS. ELLEN DAVIS (PRESIDENT) |
| Authorized Official Telephone | 7204655030 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Medical Management Company of Tyler | Former Legal Business Name - Organization |
| MPP Infusion Center of Tyler | Other Name - Individual/Organization |
| Street Address |
6115 NEW COPELAND RD STE 120.130 |
| City | TYLER |
| State | TX |
| Zip Code | 75703-6369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
| 1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
| 1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
| 1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
| 1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
| 1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
| 1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| Find all providers in zip 75703 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689648040 | Glen S Graves | Internal Medicine | 5777 New Copeland Rd, Suite 100, Tyler, TX 75703 | 2006-02-14 |
| 1770586703 | William George Brelsford | Internal Medicine | 1212 Clinic Dr, Tyler, TX 75701-2117 | 2005-05-23 |
| 1386028157 | Leanne Dada | Internal Medicine | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2015-07-12 |
| 1902225238 | Dustin Stidger | Internal Medicine | 1327 Troup Hwy, Tyler, TX 75701-4443 | 2014-04-15 |
| 1013185529 | Trinity Clinic | Internal Medicine | 1327 Troup Hwy, Tyler, TX 75701-4443 | 2008-02-19 |
| 1659317972 | Heidi E. Schneider | Internal Medicine | 1327 Troup Hwy, Tyler, TX 75701-4443 | 2006-06-22 |
| 1457395303 | Chih- Hao G Chou | Internal Medicine | 1327 Troup Hwy, Tyler, TX 75701-4443 | 2006-06-15 |
| 1225082308 | Texas Arthritis and Rheumatology | Internal Medicine | 5777 New Copeland Rd, Suite 100, Tyler, TX 75703 | 2006-05-21 |
| 1881684603 | Roger William Porter | Internal Medicine | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2005-10-24 |
| 1881690287 | Arthritis and Osteoporosis Clinic of East Texas | Internal Medicine | 1212 Clinic Dr, Tyler, TX 75701-2117 | 2005-06-22 |
| Find all providers in TYLER | ||||
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| 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.