| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1578748505 | MWANGI | JOHNSON | N | 5414 S BROADWAY AVE | TYLER | TX | 757031335 | |
| 1942558747 | THESING | AMY | MARIE | 5414 S BROADWAY AVE | TYLER | TX | 757031335 | |
| 1013483361 | TROYER | JEREMY | MICHAEL | 5414 S BROADWAY AVE | TYLER | TX | 757031335 |