Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Diabetic Renewal Center LLC

Organization Family Medicine Physician · NPI 1750764189

Diabetic Renewal Center LLC is a Family Medicine Physician in Tyler, Texas. Works from 2 locations. Licensed in Texas.

Licensed in
TX
In the registry since
2015
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1015 Pruitt Pl Ste 105
Tyler, TX 75703-1154
Phone: (903) 528-6000
Fax: (903) 526-0565
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1108 S Buffalo St, Canton, TX 75103-2304 — (903) 258-6000

Specialties & licences

Infusion Therapy Clinic/Center (primary) Taxonomy 261QI0500X · Licence 261Q10500X (TX)
Family Medicine Physician Taxonomy 207Q00000X
Family Medicine Physician Taxonomy 207Q00000X · Licence F3205 (TX)
Internal Medicine Physician Taxonomy 207R00000X

Record details

NPI number1750764189
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeff Dethlefsen — Owner · (903) 258-6000
Other names Trina Health Care Center Of Tyler Llc; Trina Health Care Center Of Tyler Llc
NPI enumeratedJuly 2, 2015
Last updated in NPPESJuly 21, 2022
Mailing address1015 Pruitt Pl Ste 105, Tyler, TX 75703-1154

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