EAST TEXAS MEDICAL CENTER TYLER (NPI# 1588913834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588913834 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS MEDICAL CENTER TYLER |
| Practice Address |
1000 S Beckham Ave Tyler TX 75701-1908 |
| Practice Telephone | 9035970351 |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2012-08-31 |
| Authorized Official Name | CHRISTI DICKSON (EXECUTIVE SECRETARY/CREDENTIALING) |
| Authorized Official Telephone | 9035963555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
678245 | TX | Hospitals |
| Street Address |
1000 S BECKHAM AVE |
| City | TYLER |
| State | TX |
| Zip Code | 75701-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740280510 | Aleksandra Olsson-detwiler | Internal Medicine | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2005-07-22 |
| 1831706431 | Kalana Sanders | Registered Nurse | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-09-28 |
| 1992333975 | Graceanne M. Dimon | Physical Therapist | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-03-27 |
| 1760021976 | Gerardo Tapia Hernandez | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2020-01-06 |
| 1861950057 | Brittany Mason Ferguson | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2019-03-06 |
| 1255801189 | Shane Ashley Correa | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-12-04 |
| 1174000962 | David Matthew Burkland | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-07-24 |
| 1598251209 | Kelsey Rene Morton | Nurse Practitioner | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-07-05 |
| 1063915916 | Tyler Regional Hospital LLC | Surgery | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-03-16 |
| 1437650264 | Tyler Regional Hospital LLC | Nurse Anesthetist, Certified Registered | 1000 S Beckham Ave, Tyler, TX 75701-1908 | 2018-02-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801840517 | Avera Tyler | General Acute Care Hospital | 240 Willow St., Tyler, MN 56178-0240 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629514203 | Tmc Bonham Hospital | General Acute Care Hospital | 504 Lispcomb Blvd, Bonham, TX 75418 | 2017-01-06 |
| 1164772216 | Methodist West Houston Hospital | General Acute Care Hospital | 5807 Grand Saline Dr, Richmond, TX 77469-6173 | 2012-09-17 |
| 1528367356 | Liberty County Hospital District No 1 | General Acute Care Hospital | 1353 N Travis, Liberty, TX 77575-3549 | 2011-03-18 |
| 1669613105 | Kingsbrook Jewish Medical Center | General Acute Care Hospital | 1404 Savoy Ct, Colleyville, TX 76034-6267 | 2009-03-12 |
| 1578724811 | Vaishali Kawaduji Bhusari | General Acute Care Hospital | 4555 Lorraine Ave, Dallas, TX 75205-3612 | 2008-06-19 |
| 1548457682 | Audie Murphy Va Hospital | General Acute Care Hospital | 4041 Merton Minter, San Antonio, TX 78229 | 2007-10-03 |
| 1033309323 | George Daniel Williamson | General Acute Care Hospital | 5087 E State Highway 22, Hamilton, TX 76531-1355 | 2007-08-01 |
| 1396861324 | Dr. Carlos F. Morales Md. | General Acute Care Hospital | 4414 Centerview Dr., Ste 168, San Antonio, TX 78228-1404 | 2007-03-21 |
| 1780786699 | Palacios Community Medical Center | General Acute Care Hospital | 311 Green Ave, Palacios, TX 77465-3213 | 2006-09-01 |
| 1033229778 | Va Hospital | General Acute Care Hospital | 8222 Lone Bridge Ln, Humble, TX 77338-1726 | 2006-08-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.