Healthcare Provider Details

I. General information

NPI: 1487698106
Provider Name (Legal Business Name): DONALD EDWARD AREGO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 OLYMPIC PLAZA 2ND FLOOR
TYLER TX
75701
US

IV. Provider business mailing address

901 TURTLE CREEK DR
TYLER TX
75701-1947
US

V. Phone/Fax

Practice location:
  • Phone: 903-596-3587
  • Fax: 903-594-2647
Mailing address:
  • Phone: 903-596-3651
  • Fax: 903-594-2038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberG3116
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: