# RADIANT MEDICAL CLINIC OF EAST TEXAS LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RADIANT MEDICAL CLINIC OF EAST TEXAS LLC
- **Other names:** Radience Wound Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1285454009
- **Legal business name:** RADIANT MEDICAL CLINIC OF EAST TEXAS LLC
- **Authorized official:** MRS. DORIS UDOSEN APRN (PRESIDENT)
- **Authorized official phone:** (903) 343-7480

## Contact information

- **Practice address:** 3613 ROCK CREEK DR, TYLER, TX 75707-1635
- **Practice address phone:** (903) 343-7480
- **Mailing address:** 3613 ROCK CREEK DR, TYLER, TX 75707-1635
- **Mailing address phone:** (903) 343-7480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | Yes |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/16/2024
- **Last updated:** 10/16/2024