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

NPI Status: Active since October 07, 2005

Contact Information

11937 US HIGHWAY 271
TYLER, TX
ZIP 75708
Phone: (903) 877-3451

Get Directions Write a Review

  • Organization
  • Neuromusculoskeletal Medicine, Sports Me...
  • Accepts Insurance

About UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER-FACILITY-PHYSICIAN

This page provides the complete NPI Profile along with additional information for University Of Texas Health Science Center At Tyler-facility-physician, a provider established in Tyler, Texas operating as a Neuromusculoskeletal Medicine, Sports Medicine. The healthcare provider is registered in the NPI registry with number 1063400778 assigned on October 2005. The practitioner's primary taxonomy code is 204C00000X. The provider is registered as an organization and their NPI record was last updated March 2026. University Of Texas Health Science Center At Tyler-facility-physician operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Daniel Deslatte (Chief Business Officer)

NPI
1063400778
Provider Name
UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER-FACILITY-PHYSICIAN
Entity Type
Organization
Location Address
11937 US HIGHWAY 271 TYLER, TX 75708
Location Phone
(903) 877-3451
Mailing Address
PO BOX 731912 DALLAS, TX 75373
Mailing Phone
(903) 877-7200
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-07-2005
Last Update Date
03-03-2026
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Neuromusculoskeletal Medicine, Sports Medicine

Taxonomy Code
204C00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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/

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208D00000XAllopathic & Osteopathic Physicians

General Practice

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Saver 750 - HMO
  • Molina Gold Saver 750 Plus with Adult Dental and Vision - HMO
  • Molina Gold Saver 750 Plus with Adult Vision - HMO
  • Molina Gold Standard - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DANIEL DESLATTE

Authorized Official Title
CHIEF BUSINESS OFFICER
Authorized Official Phone
(903) 877-7200

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
127278302MEDICAID (05)TX 

Reviews for UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER-FACILITY-PHYSICIAN

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1063400778, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
3
Unchanged
Pos 5
4
Doubled → 8
Pos 6
0
Unchanged
Pos 7
0
Doubled → 0
Pos 8
7
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 4 → 8 0 → 0 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 2 + 3 + 8 + 0 + 0 + 7 + 1 + 4 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1063400778.

Other Providers at the Same Location


The following 19 providers are registered at the same or a nearby location.

Pharmacist (Pharmacotherapy)
11937 US HIGHWAY 271, UNIVERSITY OF TEXAS HEALTH CENTER AT TYLER
TYLER, TX 75708
Nurse Practitioner (Family)
11937 US HIGHWAY 271
TYLER, TX 75708
Family Medicine
11937 US HIGHWAY 271
TYLER, TX 75708
Emergency Medicine
11937 US HIGHWAY 271
TYLER, TX 75708
Pediatrics
11937 US HIGHWAY 271
TYLER, TX 75708
Internal Medicine (Nephrology)
11937 US HIGHWAY 271
TYLER, TX 75708
Internal Medicine
11937 US HIGHWAY 271
TYLER, TX 75708
Internal Medicine (Rheumatology)
11937 US HIGHWAY 271
TYLER, TX 75708
Physician Assistant
11937 US HIGHWAY 271
TYLER, TX 75708
Radiology (Diagnostic Radiology)
11937 US HIGHWAY 271
TYLER, TX 75708
Pharmacist
11937 US HIGHWAY 271
TYLER, TX 75708
Pharmacist
11937 US HIGHWAY 271
TYLER, TX 75708
Clinic/Center (Radiology, Mobile)
11937 US HIGHWAY 271
TYLER, TX 75708
Family Medicine
11937 US HIGHWAY 271
TYLER, TX 75708
Dietitian, Registered
11937 US HIGHWAY 271
TYLER, TX 75708
Nurse Practitioner
11937 US HIGHWAY 271
TYLER, TX 75708
Psychologist
11937 US HIGHWAY 271
TYLER, TX 75708
Internal Medicine
11937 US HIGHWAY 271, UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER TYLER
TYLER, TX 75708
Physical Therapist
11937 US HIGHWAY 271
TYLER, TX 75708

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063400778, enumerated as an "organization" on October 07, 2005.

The provider is located at 11937 US HIGHWAY 271 TYLER, TX 75708 and the phone number is (903) 877-3451.

Neuromusculoskeletal Medicine, Sports Medicine with taxonomy code 204C00000X.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.