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PURE RADIANCE LASER RETREAT
NPI 1013306273
Family Medicine in Tyler, TX

Active since January 12, 2015
6722 S BROADWAY AVE, TYLER, TX 75703(903) 561-0300 Get Directions Write a Review

NPPES record last updated: January 12, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pure Radiance Laser Retreat NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PURE RADIANCE LASER RETREAT (NPI 1013306273) is a healthcare organization registered as a family medicine in Tyler, Texas and active in the NPI registry since January 2015. The organization lists Mack D Stewart, Owner/m.d., as its authorized official.

NPPES Registry Identity

NPI1013306273
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePURE RADIANCE LASER RETREAT
Location Address6722 S BROADWAY AVETyler, TX 75703-4730
Mailing Address6722 S Broadway AveTyler, TX 75703-4730 · (903) 561-0300
Phone(903) 561-0300
Organization SubpartNo
Authorized OfficialMack D StewartOwner/m.d. · (903) 561-0300
Enumeration DateJanuary 12, 2015
✔ NPI 1013306273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
6722 S BROADWAY AVE, Tyler, TX 75703
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pure Radiance Laser Retreat's NPI number?

The NPI number for Pure Radiance Laser Retreat is 1013306273. It was assigned to this organization in the NPPES registry on January 12, 2015.

Where is Pure Radiance Laser Retreat located?

Pure Radiance Laser Retreat is located at 6722 S Broadway Ave, Tyler, TX 75703. The listed phone number is (903) 561-0300.

What is Pure Radiance Laser Retreat's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Pure Radiance Laser Retreat was last updated on January 12, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.