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DIABETIC RENEWAL CENTER LLC
NPI 1750764189
Clinic/Center - Infusion Therapy in Tyler, TX

Active since July 02, 2015
1015 PRUITT PL STE 105, TYLER, TX 75703(903) 528-6000(903) 526-0565 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Jun 22, 2017 and 3 more (6 updates tracked since 2016).

About Diabetic Renewal Center Llc NPPES

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

DIABETIC RENEWAL CENTER LLC (NPI 1750764189), doing business as Trina Health Care Center Of Tyler Llc, is a healthcare organization registered as an infusion therapy in Tyler, Texas and active in the NPI registry since July 2015. The organization maintains a secondary practice location in Canton and lists Jeff E Dethlefsen, Owner, as its authorized official.

NPPES Registry Identity

NPI1750764189
Entity TypeOrganization
Primary Taxonomy261QI0500X
Legal Business NameDIABETIC RENEWAL CENTER LLC
Location Address1015 PRUITT PL STE 105Tyler, TX 75703-1154
Mailing Address1015 Pruitt Pl Ste 105Tyler, TX 75703-1154 · (903) 258-6000 · Fax (903) 526-0565
Phone(903) 528-6000
Fax(903) 526-0565
Organization SubpartNo
Authorized OfficialJeff E DethlefsenOwner · (903) 258-6000
Enumeration DateJuly 2, 2015
Last NPPES UpdateJuly 21, 20226 updates tracked since enumeration
✔ NPI 1750764189 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Infusion TherapyAmbulatory Health Care Facilities
Taxonomy Code261QI0500X
License✔ Licensed in TX · 261Q10500X
Also ListedFamily MedicineTaxonomy 207Q00000X · License F3205 (TX)
Also ListedInternal MedicineTaxonomy 207R00000X
1015 PRUITT PL STE 105, Tyler, TX 75703
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Other Names 1

Former Legal Business NameTrina Health Care Center Of Tyler Llc

Secondary Practice Location 1

Location 11108 S Buffalo StCanton, TX 75103-2304 · Phone (903) 258-6000 · Fax (903) 526-0565

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 Diabetic Renewal Center LLC's NPI number?

The NPI number for Diabetic Renewal Center LLC is 1750764189. It was assigned to this organization in the NPPES registry on July 2, 2015. The provider was formerly known as Trina Health Care Center Of Tyler LLC.

Where is Diabetic Renewal Center LLC located?

Diabetic Renewal Center LLC is located at 1015 Pruitt Pl Ste 105, Tyler, TX 75703. The listed phone number is (903) 528-6000.

What is Diabetic Renewal Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Infusion Therapy, with taxonomy code 261QI0500X.

When was this NPI record last updated?

The NPPES record for Diabetic Renewal Center LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.