Healthcare Provider Details
I. General information
NPI: 1588550529
Provider Name (Legal Business Name): TOTAL POINT ER TYLER BROADWAY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6718 S BROADWAY AVE
TYLER TX
75703-4730
US
IV. Provider business mailing address
1601 ELM ST STE 4210
DALLAS TX
75201-7282
US
V. Phone/Fax
- Phone: 469-607-8448
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFF
LOVE
Title or Position: MANAGER
Credential:
Phone: 469-607-8448