Organization
LINDA DEMANOU
Active
Parent organization
CHOICE SUPPORTIVE CARE TEAM INC.
Other names
Choice Supportive Care Team
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHOICE SUPPORTIVE CARE TEAM INC.
Authorized official
LINDA DEMANOU NP (NP)
(240) 701-6437
Entity
Organization
Contact information
Practice address
4293 KINSEY DR, TYLER, TX 75703-1004
(903) 592-5670
(888) 960-2797
Mailing address
9375 CHISHOLM TRL, TYLER, TX 75703-0411
(903) 521-0385
(888) 960-2797
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP145557
STATE LICENSE
TX
Enumeration date
06/23/2021
Last updated
06/23/2021
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