Organization
CHOICE SUPPORTIVE CARE TEAM INC.
Active
Organization
CHOICE SUPPORTIVE CARE TEAM INC.
Active
Other names
Express Health Systems, Choice Supportive Care Team
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN HOLLEY (CAO)
(903) 592-5670
Entity
Organization
Contact information
Practice address
120 E SOUTH TOWN DR STE 100, TYLER, TX 75703-4747
(903) 925-6705
(903) 209-2888
Mailing address
120 E SOUTH TOWN DR STE 100, TYLER, TX 75703-4747
(903) 592-5670
(903) 209-2888
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
207QA0505X
Adult Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00654697
RAIL ROAD
TX
Enumeration date
02/05/2020
Last updated
11/01/2022
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