Individual
ANNA POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2115 S BROADWAY AVE, TYLER, TX 75701-4214
(903) 907-7002
Mailing address
PO BOX 746079, ATLANTA, GA 30374-6079
(312) 733-9730
(773) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
175360
NY
207R00000X
Internal Medicine Physician
57800
TN
207R00000X
Internal Medicine Physician
Primary
R8811
TX
Other
Enumeration date
09/01/2016
Last updated
08/09/2023
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