ALEX DETWILER, M.D., P.A.
Medical Practice at Beckham Ave, Tyler, TX

License number
Texas L1685
Category
Medical Practice
Type
Specialist
Owner
Name: DR. ALEKSANDRA OLSSON-DETWILER M.D.
Title: OWNER
Phone: (903) 521-7838
Address
Address
1000 S Beckham Ave, Tyler, TX 75701
National Provider ID: 1073601118
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ALEX DETWILER, M.D., PA

Tyler, TX

Industry:
Medical Doctor's Office
Doing business as:
Alex Detwiler, M.D., PA
Registration:
Jun 28, 2004
Addresses:
3635 Cyn Crk Cir, Tyler, TX 75707 (Mailing)
PO Box 132601, Tyler, TX 75713
State ID:
0800359098
Business type:
Professional Association
President , Treasurer , Director , Member , Secretary , Vice-President:
Alex Detwiler (President , Treasurer , Director , Member , Secretary , Vice-President)
Agent:
Alexandra Olsson Detwiler,3635 Cyn Crk Cir, Tyler, TX 75707 (Physical)
TIN:
14320543185

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