UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER (NPI# 1780628099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780628099 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER |
| Other Organization Name | UTHSCT HOPE TYLER |
| Practice Address |
721 Clinic Dr Ste B Tyler TX 75701-2043 |
| Practice Telephone | 9035957086 |
| Practice Fax Number | 9035263914 |
| Mailing Telephone | 9035957086 |
| Mailing Fax Number | 9035263914 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-09-09 |
| Authorized Official Name | KRIS KAVASCH (VP FINANCE/CFO) |
| Authorized Official Telephone | 9038777399 |
| Authorized Official Credential | AO |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY OF TEXAS HEALTH CENTER AT TYLER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1455591 | 05 | |
| PK | 2098716 | 01 |
| Other Name | Type Code |
|---|---|
| THO PHARMACY | Doing Business As Name - Organization |
| UTHSCT HOPE TYLER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003215401 | University of Texas Health Science Center At Tyler | Psychiatric Unit | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2014-08-21 |
| 1992868186 | University of Texas Health Science Center At Tyler | Nurse Anesthetist, Certified Registered | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2006-12-18 |
| 1417941295 | University of Texas Health Science Center At Tyler | Clinic/Center | 11937 Us Highway 271, Tyler, TX 75708-3154 | 2005-09-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER, THE | 11937 Us Hwy 271, Tyler, TX 75708-3154 |
| Street Address |
721 CLINIC DR STE B |
| City | TYLER |
| State | TX |
| Zip Code | 75701-2043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508485871 | Tyler Carerx LLC | Pharmacy | 1007 E 2nd St, Tyler, TX 75701-3312 | 2020-04-15 |
| 1225498991 | Savrx Pharmacy, Inc | Pharmacy | 6100 S. Broadway Ave, Suite 160, Tyler, TX 75703 | 2016-02-24 |
| 1043684228 | Fred's Stores of Tennessee Inc. | Pharmacy | 1803 E Gentry Pkwy, Tyler, TX 75702-3564 | 2015-11-25 |
| 1962874602 | Brookshire Grocery Company | Pharmacy | 172 Centennial Pkwy, Tyler, TX 75703 | 2015-10-21 |
| 1619143732 | Brookshire Grocery Company | Pharmacy | 1600 Wsw Loop 323, Tyler, TX 75701-8532 | 2008-05-08 |
| 1750485587 | Cvs Pharmacy Inc | Pharmacy | 4922 S Broadway Ave, Tyler, TX 75703-1324 | 2006-09-12 |
| 1235243221 | Majors Pharmacy Inc | Pharmacy | 108 Shelley Dr, Tyler, TX 75701-8723 | 2006-08-18 |
| 1700808458 | Cvs Pharmacy Inc | Pharmacy | 7003 S Broadway Ave, Tyler, TX 75703-4737 | 2006-07-24 |
| 1356955587 | American Specialty Pharmacy Inc | Pharmacy | 1109 E 5th St, Tyler, TX 75701-3318 | 2020-09-04 |
| 1336751270 | Stephenson Pharmacy, LLC | Pharmacy | 1000 S Fleishel Ave, Tyler, TX 75701-2037 | 2020-08-21 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.