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Individual

C. RENEE BRANCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1910 ROSELAND BLVD, TYLER, TX 75701-4246
(903) 533-0644
(903) 592-7849
Mailing address
1910 ROSELAND BLVD, TYLER, TX 75701-4246
(903) 533-0644
(903) 592-7849

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L1526
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0078JE
BLUE CROSS BLUE SHIELD
TX
05
151719501
TX
01
8JK361
BCBS
TX
01
P02097550
MCRR
TX
Enumeration date
01/05/2006
Last updated
03/12/2020
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