Organization
TYLER ER OPERATIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN DANIEL BOHANNON (OWNER/OPERATIONS MANAGER)
(281) 236-0563
Entity
Organization
Contact information
Practice address
3943 OLD JACKSONVILLE HWY, TYLER, TX 75701
(903) 753-1212
(281) 836-6106
Mailing address
5103 KOBERLIN ST, TYLER, TX 75703-5608
(903) 753-1212
(281) 836-6106
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
160253
TX
Other
Enumeration date
04/14/2016
Last updated
01/16/2017
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