Azalea Orthopedic & Sports Medicine Clinic PA
Organization Active NPI Orthopaedic Surgery Physician · Tyler, TX
NPI 1699765107 · NPPES record last updated Jan 28, 2019
Key facts
- NPI
- 1699765107
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- AZALEA ORTHOPEDIC & SPORTS MEDICINE CLINIC PA
- Practice address
- 3414 Golden Road
Tyler, TX 75701 - Phone
- (903) 939-7500
- Fax
- (903) 939-7728
- NPI assigned
- Oct 26, 2005
- Organization subpart
- No
Authorized official
- Name
- Heidi Ebert
- Title
- Billing Supervisor
- Phone
- (903) 939-7774
Practitioners 17
-
Roger F Bowers, PA
-
Jeri Swaim Brown, FNP
-
Cathi Lynne Eggart, FNP-C
-
Teresa Lee Griffin, DNP APRN AGACNP FNP
-
James Wayne McKinley, M.D.
-
Sheila B. Patel, DO
-
Enrique C Quiambao, FNP-C
-
Gary Lynn Rhame, D.O.
-
Jordan Nicole Sparks, COTA
-
Cynthia Gayle Weston, FNP
-
Caitlin Nicole Wilkins, ATC, LAT
-
Tracy Lynn Gaudu, PA-C
-
Brock Lewis Smith, PA-C
-
Talent H. Teoh, MD
National Provider Directory
Locations
203 Nacogdoches St
Ste 350
Jacksonville, TX 75766
Phone (903) 586-6841
1537 E Grande Blvd
Ste 100
Tyler, TX 75703
Phone (903) 630-7267
1905 S Donnybrook Ave
Tyler, TX 75701
Phone (903) 592-6811
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes | ||
| Durable Medical Equipment & Medical Supplies | 332B00000X | 0863040001 | TX |
Addresses
Primary practice location
3414 Golden Road
Tyler, TX 75701
Mailing address
PO Box 610307
Dallas, TX 75261-0307
Phone (903) 939-7500
Other practice location 1
1814 Roseland Blvd Ste 100
Tyler, TX 75701-4262
Phone (903) 525-3300
Other practice location 2
203 Nacogdoches St Ste 350
Jacksonville, TX 75766-2454
Phone (903) 939-7536
Other practice location 3
2211 S Loop 256
Palestine, TX 75801-4701
Phone (903) 939-7500
Other practice location 4
2701 US Highway 271 N
Pittsburg, TX 75686-4289
Phone (903) 946-5442
Other practice location 5
725 N 4th St
Longview, TX 75601-5412
Phone (903) 939-7501
Other practice location 6
305 W 20th St
Mount Pleasant, TX 75455-2327
Phone (903) 577-5661
Other practice location 7
4800 NE Stallings Dr Ste 110
Nacogdoches, TX 75965-1250
Phone (903) 939-7500
Other practice location 8
6444 State Highway 19 S
Athens, TX 75751-8968
Phone (903) 939-7501
Other practice location 9
8101 S Broadway Ave
Tyler, TX 75703-5469
Phone (903) 939-7501
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 084034001 | Medicaid | TX | |
| 084034002 | Medicaid | TX |
Other providers in Tyler, TX
- Austilar Ayoka
- Macy Ayres
- Azalea
- Azalea Academy for Exceptional Adults
- Azalea Internal Medicine Associates PA
- Azalea Place Operating Company
- Samareh Cunningham Azar
- Jasmine Azghani Vardeman
- Azleway Inc.
- Naga Azzarapu
All providers in Tyler, TX · Orthopaedic Surgery Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.