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UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER-FACILITY-PHYSICIAN
NPI 1063400778
Neuromusculoskeletal Medicine, Sports Medicine in Tyler, TX

Active since October 07, 2005
11937 US HIGHWAY 271, TYLER, TX 75708(903) 877-3451 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About University Of Texas Health Science Center At Tyler-facility-physician NPPES

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

UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER-FACILITY-PHYSICIAN (NPI 1063400778) is a healthcare organization registered as a neuromusculoskeletal medicine, sports medicine in Tyler, Texas and active in the NPI registry since October 2005. The organization lists Daniel Deslatte, Chief Business Officer, as its authorized official.

NPPES Registry Identity

NPI1063400778
Entity TypeOrganization
Primary Taxonomy204C00000X
Legal Business NameUNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER-FACILITY-PHYSICIAN
Location Address11937 US HIGHWAY 271Tyler, TX 75708-3154
Mailing AddressPo Box 731912Dallas, TX 75373-1912 · (903) 877-7200
Phone(903) 877-3451
Organization SubpartNo
Authorized OfficialDaniel DeslatteChief Business Officer · (903) 877-7200
Enumeration DateOctober 7, 2005
Last NPPES UpdateMarch 3, 2026
NPPES CertifiedMarch 3, 2026
✔ NPI 1063400778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNeuromusculoskeletal Medicine, Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code204C00000X
Definition
A Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Source: American Osteopathic Association Additional Resources: AOA Osteopathic Board Certification in Neuromusculoskeletal Medicine; https://certification.osteopathic.org/sports-medicine/
Also ListedGeneral PracticeTaxonomy 208D00000X
11937 US HIGHWAY 271, Tyler, TX 75708
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Other Identifiers 1

Medicaid127278302TX

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER
Psychiatric Unit
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7200
TYLER DAVIS DO
Surgery (Trauma Surgery)
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7777
PATRICIA DIANNE SHACKELFORD
Pharmacist
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7088
JENNIFER ANNISA MATHEW DO
Student in an Organized Health Care Education/Training Program
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7200
JASMINE MARIE GAMBOA MD
Student in an Organized Health Care Education/Training Program
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7200
DR. SADIE ROSE WALTER DO
Student in an Organized Health Care Education/Training Program
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7200
RENDALL NORTHCUTT FNP
Nurse Practitioner (Primary Care)
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7200
ES-HAQ SADDELDIN HASSANIN DO
Hospitalist
11937 US HIGHWAY 271
TYLER, TX 75708
Smith County (903) 877-7253

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 University Of Texas Health Science Center At Tyler-Facility-Physician's NPI number?

The NPI number for University Of Texas Health Science Center At Tyler-Facility-Physician is 1063400778. It was assigned to this organization in the NPPES registry on October 7, 2005.

Where is University Of Texas Health Science Center At Tyler-Facility-Physician located?

University Of Texas Health Science Center At Tyler-Facility-Physician is located at 11937 Us Highway 271, Tyler, TX 75708. The listed phone number is (903) 877-3451.

What is University Of Texas Health Science Center At Tyler-Facility-Physician's specialty?

The primary specialty registered for this NPI is Neuromusculoskeletal Medicine, Sports Medicine with taxonomy code 204C00000X.

What insurance does University Of Texas Health Science Center At Tyler-Facility-Physician accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list University Of Texas Health Science Center At Tyler-Facility-Physician as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for University Of Texas Health Science Center At Tyler-Facility-Physician was last updated on March 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.