Organization
NEURO IR OF EAST TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BLACK (PRACTICE ADMINISTRATOR)
(903) 705-0072
Entity
Organization
Contact information
Practice address
700 OLYMPIC PLAZA CIR STE 910, TYLER, TX 75701-1915
(903) 705-0072
(903) 705-0068
Mailing address
700 OLYMPIC PLAZA CIR STE 910, TYLER, TX 75701-1915
(903) 705-0072
(903) 705-0068
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
—
—
Other
Enumeration date
10/03/2017
Last updated
11/04/2023
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