Organization
NORTHEAST TEXAS PUBLIC HEALTH DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE T. ROBERTS JR. FACHE (CHIEF EXECUTIVE OFFICER)
(903) 535-0036
Entity
Organization
Contact information
Practice address
815 N. BROADWAY, TYLER, TX 75702-4507
(903) 535-0033
(903) 535-0052
Mailing address
815 N BROADWAY AVE, TYLER, TX 75702-4507
(903) 535-0033
(903) 535-0052
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
01/25/2006
Last updated
09/26/2024
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