Individual
IVAN ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2202 WNW LOOP 323 APT 614, TYLER, TX 75702-1165
(903) 830-2342
Mailing address
2202 WNW LOOP 323 APT 614, TYLER, TX 75702-1165
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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