Individual
JULIE ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
910 E HOUSTON ST, STE. 330, TYLER, TX 75702-8369
(903) 525-7995
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
611703
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170015502
—
TX
01
—
75-2616977-095
TRICARE
TX
01
—
8Y1425
BCBS
TX
01
—
TIN PLUS SUFFIX 066
TRICARE
TX
Enumeration date
01/26/2007
Last updated
11/17/2015
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