OrganizationActive
Advanced Wellness
NPI 1427540806 · Internal Medicine Physician · Tyler, TX
Provider details
- NPI number
- 1427540806
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Advwellness, LLC
- Authorized official
- Roxanne Wheeler, Credentialing Specialist
Practice location
5605 Old Bullard Rd Ste B
Tyler, TX 75703
Phone: (903) 630-5595
Fax: (903) 630-5599
Mailing address
212 Old Grande Blvd Ste A200
Tyler, TX 75703-4204
Registry dates
- Enumerated
- 2018-06-01
- Last updated
- 2018-09-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.