Vail, Theresa Marie
Vail, Theresa Marie is an individual health care provider with primary practice located at 606 S Fleishel Ave , Tyler TX 75701-2012. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Vail, Theresa Marie can be contacted via phone (903) 595-5500.Contact Information
Primary practice address
606 S Fleishel Ave
Tyler TX 75701-2012
Phone: (903) 595-5500
Fax: (903) 595-5506
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | L0672 | Texas |
Profile Details
NPI number | 1700885605 |
---|---|
LBN Legal business name | Vail, Theresa Marie |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 21st, 2005 |
Last updated | Nov 20th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1700885605 | NPPES |
Texas | MEDICAID | 0392920-03 | |
Texas | Other | 731682660 | |
Texas | Other | 8AJ103 | |
Texas | Other | P00039903 |
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