# THE PHYSICIAN'S CLINIC, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942531124
- **Authorized official:** ANDREW E BENTLEY MD (PRESIDENT)
- **Authorized official phone:** (903) 561-7030

## Contact information

- **Practice address:** 921 SHILOH RD, STE C100, TYLER, TX 75703-1431
- **Practice address phone:** (903) 561-7030
- **Practice address fax:** (903) 561-7073
- **Mailing address:** 921 SHILOH RD, STE C100, TYLER, TX 75703-1431
- **Mailing address phone:** (903) 561-7030
- **Mailing address fax:** (903) 561-7073

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | J8455 | TX | Yes |

## Other

- **Enumeration date:** 01/27/2010
- **Last updated:** 01/27/2010