Organization
ANDREWS CENTER - MR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL FONTENOT (CFO)
(903) 597-1351
Entity
Organization
Contact information
Practice address
2323 W FRONT ST, TYLER, TX 75702-7704
(903) 597-1351
Mailing address
2323 W FRONT ST, TYLER, TX 75702-7704
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138365506
—
TX
Enumeration date
12/12/2006
Last updated
08/15/2022
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