Northeast Texas Neurology Associates, P.A.

LBN: Northeast Texas Neurology Associates, P.A.
Northeast Texas Neurology Associates, P.A. is an health care organization with primary practice located at 505 S Fleishel Ave , Tyler TX 75702-8413. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as the primary health care specialty. Northeast Texas Neurology Associates, P.A. can be contacted via phone (903) 526-7055, or through Jetter, Gina M. via phone (903) 526-7055.

Contact Information

Primary practice address
505 S Fleishel Ave Tyler TX 75702-8413
Phone: (903) 526-7055
Fax: (903) 593-4303
Website:
Map and Directions
Authorized official contact:
Name: Jetter, Gina M. Doctor of Medicine (MD)
Phone: (903) 526-7055

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X E6235 Texas

Profile Details

NPI number 1972680130
LBN Legal business name Northeast Texas Neurology Associates, P.A.
DBA Doing business as
Authorized official Jetter, Gina M. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 1st, 2006
Last updated Aug 16th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972680130 NPPES
Texas MEDICAID 115025205
Texas MEDICAID 143629701

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