Azalea Orthopedic & Sports Medicine Clinic Pa

LBN: Azalea Orthopedic & Sports Medicine Clinic Pa
Azalea Orthopedic & Sports Medicine Clinic Pa is an health care organization with primary practice located at 3414 Golden Road , Tyler TX 75701. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Suppliers / Durable Medical Equipment & Medical Supplies. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is the primary health care specialty. Azalea Orthopedic & Sports Medicine Clinic Pa can be contacted via phone (903) 939-7500, or through Ebert, Heidi via phone (903) 939-7774.

Contact Information

Primary practice address
3414 Golden Road Tyler TX 75701
Phone: (903) 939-7500
Fax: (903) 939-7728
Website:
Map and Directions
Authorized official contact:
Name: Ebert, Heidi
Phone: (903) 939-7774

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X 0863040001 Texas

Profile Details

NPI number 1699765107
LBN Legal business name Azalea Orthopedic & Sports Medicine Clinic Pa
DBA Doing business as
Authorized official Ebert, Heidi
Entity Organization
Organization subpart 1 No
Enumeration date Oct 26th, 2005
Last updated Jan 28th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699765107 NPPES
Texas MEDICAID 084034001
Texas MEDICAID 084034002

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