East Lake Medical, PLLC
East Lake Medical, PLLC is a Nurse Practitioner in Tyler, Texas. Registered with an NPI since 2022.
- In the registry since
- 2022
What do these letters mean?
- PLLC — Professional limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
11980 State Highway 64 E Ste GTyler, TX 75707-2541
Phone: (903) 650-8619
Fax: (903) 650-8576
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nurse Practitioner (primary) | Taxonomy 363L00000X |
|---|
Record details
| NPI number | 1497494777 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jena Decanter — Nurse Practitioner · (903) 650-8619 |
| NPI enumerated | June 3, 2022 |
| Last updated in NPPES | June 3, 2022 |
| Certification date | June 3, 2022 |
| Mailing address | 11980 State Highway 64 E Ste G, Tyler, TX 75707-2541 |
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