Desta, Minale

Desta, Minale is an individual health care provider with primary practice located at 800 E Dawson St , Tyler TX 75701. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Desta, Minale can be contacted via phone (903) 593-8441.

Contact Information

Primary practice address
800 E Dawson St Tyler TX 75701
Phone: (903) 593-8441
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X R6380 Texas
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1477948701
LBN Legal business name Desta, Minale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2015
Last updated Apr 2nd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477948701 NPPES
Texas Other 8MB039 BCBS
Texas Other 898895 BCBS

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