Individual
DR. CARRIE DANAE TUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 531-4500
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
BP10028434
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283517503
—
TX
05
—
283617504
—
TX
01
—
75-2616977-042
TRICARE
TX
01
—
P01502448
RAIL ROAD
TX
Enumeration date
07/17/2008
Last updated
10/31/2015
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