Individual
ERIC BRADLEY VOGT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 606-5864
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP145418
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1C6316
MEDICARE
TX
01
—
8MR185
BCBS
TX
Enumeration date
04/16/2020
Last updated
07/15/2024
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