Organization
COMMUNITY HEALTH CLINIC OF NORTHEAST TEXAS
Active
Other names
ST. PAUL'S MOBILE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY DAVIS MBA,MHA (EXECUTIVE DIRECTOR)
(903) 533-7404
Entity
Organization
Contact information
Practice address
928 N GLENWOOD BLVD, TYLER, TX 75702-5055
(903) 533-7400
Mailing address
815 N BROADWAY AVE, TYLER, TX 75702-4507
(903) 535-0023
(903) 535-0052
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/19/2007
Last updated
11/19/2007
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