UT HEALTH EAST TEXAS PHYSICIANS OVERTON
NPI 1689496812
Clinic/Center - Rural Health in Overton, TX

Active since October 29, 2024CLIA 45D2015579 · Waiver
102 W HENDERSON ST, OVERTON, TX 75684(903) 834-0201(903) 834-0264 Get Directions Write a Review

NPPES record last updated: December 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ut Health East Texas Physicians Overton NPPES

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

UT HEALTH EAST TEXAS PHYSICIANS OVERTON (NPI 1689496812) is a healthcare organization registered as a rural health in Overton, Texas and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through December 31, 2027 and lists Daniel Deslatte, Chief Business Officer, as its authorized official.

NPPES Registry Identity

NPI1689496812
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameUNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER-FACILTY-PHYSICIAN
Location Address102 W HENDERSON STOverton, TX 75684-1613
Mailing Address11937 Us Highway 271Tyler, TX 75708-3154 · (903) 877-7200
Fax(903) 834-0264
Organization SubpartNo
Authorized OfficialDaniel DeslatteChief Business Officer · (903) 877-7200
Enumeration DateOctober 29, 2024
Last NPPES UpdateDecember 17, 2024
NPPES CertifiedDecember 17, 2024
NPI 1689496812 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
102 W HENDERSON ST, Overton, TX 75684

Other Names 1

Doing Business AsUt Health East Texas Physicians Overton

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2015579

Ut Health East Texas Physicians Overton · Overton, TX
Active · expires Dec 31, 2027
CLIA Number45D2015579
Laboratory TypeRural Health Clinic
Certificate Effective DateJanuary 1, 2026
Certificate Expiration DateDecember 31, 2027
Laboratory DirectorLeo M. Holm
Laboratory Phone(903) 834-0201
Laboratory LocationUt Health East Texas Physicians Overton102 W Henderson St, Overton, TX 75684
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

Clinic/Center (Dental)
102 W HENDERSON ST
OVERTON, TX 75684
Nurse Practitioner (Family)
102 W HENDERSON ST
OVERTON, TX 75684
Physician Assistant
102 W HENDERSON ST
OVERTON, TX 75684

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-Facilty-Physician's NPI number?

The NPI number for University Of Texas Health Science Center At Tyler-Facilty-Physician is 1689496812. It was assigned to this organization in the NPPES registry on October 29, 2024. The provider is doing business as Ut Health East Texas Physicians Overton.

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

University Of Texas Health Science Center At Tyler-Facilty-Physician is located at 102 W Henderson St, Overton, TX 75684. The listed phone number is (903) 834-0201.

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

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does University Of Texas Health Science Center At Tyler-Facilty-Physician hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2015579) is associated with this NPI, valid through December 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for University Of Texas Health Science Center At Tyler-Facilty-Physician was last updated on December 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.