Vail, Theresa Marie

Vail, Theresa Marie is an individual health care provider with primary practice located at 606 S Fleishel Ave , Tyler TX 75701-2012. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Vail, Theresa Marie can be contacted via phone (903) 595-5500.

Contact Information

Primary practice address
606 S Fleishel Ave Tyler TX 75701-2012
Phone: (903) 595-5500
Fax: (903) 595-5506
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X L0672 Texas

Profile Details

NPI number 1700885605
LBN Legal business name Vail, Theresa Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Nov 20th, 2014 - about 12 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 1700885605 NPPES
Texas MEDICAID 0392920-03
Texas Other 731682660
Texas Other 8AJ103
Texas Other P00039903

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