RADIANT MEDICAL CLINIC OF EAST TEXAS LLC
NPI 1285454009
Nurse Practitioner - Gerontology in Tyler, TX
About Radiant Medical Clinic Of East Texas Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RADIANT MEDICAL CLINIC OF EAST TEXAS LLC (NPI 1285454009), doing business as Radience Wound Care, is a healthcare organization registered as a gerontology in Tyler, Texas and active in the NPI registry since October 2024. The organization lists Doris Udosen, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Radiant Medical Clinic Of East Texas LLC's NPI number?
The NPI number for Radiant Medical Clinic Of East Texas LLC is 1285454009. It was assigned to this organization in the NPPES registry on October 16, 2024. The provider is doing business as Radience Wound Care.
Where is Radiant Medical Clinic Of East Texas LLC located?
Radiant Medical Clinic Of East Texas LLC is located at 3613 Rock Creek Dr, Tyler, TX 75707. The listed phone number is (903) 343-7480.
What is Radiant Medical Clinic Of East Texas LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
When was this NPI record last updated?
The NPPES record for Radiant Medical Clinic Of East Texas LLC was last updated on October 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.
# Radiant Medical Clinic Of East Texas Llc · NPI 1285454009
Gerontology organization in Tyler, Texas. Organization record, active in the CMS NPPES registry since October 16, 2024.
## Identity
- **NPI:** 1285454009 (Entity type: Organization)
- **Enumerated:** October 16, 2024
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **Also known as:** Radience Wound Care (Doing Business As)
- **Organization subpart:** Yes (part of Radiant Medical Clinic Of East Texas Llc)
- **Authorized official:** Doris Udosen, PRESIDENT
## Practice location
- **Address:** 3613 ROCK CREEK DR, Tyler, TX 75707-1635
- **Phone:** (903) 343-7480
## Record status
- **NPPES last updated:** October 16, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1285454009) · Data from the CMS NPPES public registry.