Individual
MICHAEL GILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2259 BROUSSARD ST, TYLER, TX 75701-8479
(903) 920-6453
Mailing address
2259 BROUSSARD ST, TYLER, TX 75701-8479
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
1364261
TX
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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