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Organization
UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER-FACILITY-PHYSICIAN
Active
Organization
UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER-FACILITY-PHYSICIAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL DESLATTE (CHIEF BUSINESS OFFICER)
(903) 877-7200
Entity
Organization
Contact information
Practice address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-3451
Mailing address
PO BOX 731912, DALLAS, TX 75373-1912
(903) 877-7200
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
NULL
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
Other
Enumeration date
10/07/2005
Last updated
03/03/2026
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