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Individual

MRS. ANGELA POOLE CABANISS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
910 E HOUSTON ST STE 230, TYLER, TX 75702-8364
(903) 606-7300
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP126941
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
343293201
TX
01
75-2616977-020
TRICARE
TX
01
75-2616977-023
TRICARE
TX
01
8E75NN
BCBS
TX
01
P01439639
RAIL ROAD MEDICARE
TX
Enumeration date
11/18/2014
Last updated
07/16/2025
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