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Organization
THE PHYSICIAN'S CLINIC, PA
Active
Organization
THE PHYSICIAN'S CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW E BENTLEY MD (PRESIDENT)
(903) 561-7030
Entity
Organization
Contact information
Practice address
921 SHILOH RD, STE C100, TYLER, TX 75703-1431
(903) 561-7030
(903) 561-7073
Mailing address
921 SHILOH RD, STE C100, TYLER, TX 75703-1431
(903) 561-7030
(903) 561-7073
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
J8455
TX
Other
Enumeration date
01/27/2010
Last updated
01/27/2010
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