Provider Type Icon

PHOENIX HEALTH CENTER PLLC NPI 1295157337


NPI Information

NPI: 1295157337
Provider Name: PHOENIX HEALTH CENTER, PLLC

Doing Business As: PHOENIX HEALTH CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 45D2074345

Address:
1114 W BOW ST
TYLER, TX
ZIP 75702
Phone: (903) 595-5595
Get Directions

PHOENIX HEALTH CENTER, PLLC is a family medicine in Tyler, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PHOENIX HEALTH CENTER, PLLC NPI is 1295157337. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Phoenix Health Center.

The provider's business location address is:

1114 W BOW ST
TYLER, TX
ZIP 75702-137
Phone: (903) 595-5595
Fax: (903) 595-5985

The provider's authorized official is Dorothy Louise Jackson .
The authorized official title is Sole Owner and has the following contact phone number (903) 595-5595.

The CLIA number assigned to this NPI record is 45D2074345 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/8/2014 and was last updated on 6/24/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineN1355TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.