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Contact Information

ADVANCED WELLNESS
5605 OLD BULLARD RD STE B
TYLER, TX75703
 Phone: 903-630-5595
 Fax: 903-630-5599
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ADVANCED WELLNESS · (Female)

NPI # 1427540806
Status Active
Credentials
Entity Individual
Enumeration date 06/01/2018
Last updated 09/17/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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