Individual
COLLINS TITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2151 FRANKSTON HWY, TYLER, TX 75701-3808
(903) 405-6197
Mailing address
322 AMBROSE AVE, TYLER, TX 75704-2028
(713) 552-3982
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
56011
TX
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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