Basic Information
| Provider Information | |||||||||
| NPI: | 1992468920 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEUENSCHWANDER | ||||||||
| FirstName: | TAMARA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10849 DEER CREEK DR | ||||||||
| Address2: | |||||||||
| City: | TYLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757075384 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9033124584 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4111 UNIVERSITY BLVD | ||||||||
| Address2: | |||||||||
| City: | TYLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757016623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9032663400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2021 | ||||||||
| LastUpdateDate: | 03/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 03/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 864220 | TX | Y | Nursing Service Providers | Registered Nurse |
No ID Information.