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General NPI Number Information
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NPI Number | 1235232372
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF TEXAS HEALTH CENTER AT TYLER
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 11937 US HIGHWAY 271
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City | TYLER
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State | TX
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Zip | 75708-3154
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Country | US
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Telephone | 903-877-7088
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Fax | 903-877-7006
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Provider Business Mailing Address
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Address Line | 11937 US HIGHWAY 271
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City | TYLER
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State | TX
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Zip | 75708-3154
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Country | US
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Telephone | 903-877-7088
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Fax | 903-877-7006
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Authorized Official
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Title or Position | CHIEF BUSINESS OFFICER
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Name | DANIEL DESLATTE
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Credential |
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Telephone | 903-877-5077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 6038
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License Number State | TX
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