Organization
RADIANT MEDICAL CLINIC OF EAST TEXAS LLC
Active
Parent organization
RADIANT MEDICAL CLINIC OF EAST TEXAS LLC
Other names
Radience Wound Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
RADIANT MEDICAL CLINIC OF EAST TEXAS LLC
Authorized official
MRS. DORIS UDOSEN APRN (PRESIDENT)
(903) 343-7480
Entity
Organization
Contact information
Practice address
3613 ROCK CREEK DR, TYLER, TX 75707-1635
(903) 343-7480
Mailing address
3613 ROCK CREEK DR, TYLER, TX 75707-1635
(903) 343-7480
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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