Organization
CPAT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW KULAGA MD (PRESIDENT)
(903) 593-0481
Entity
Organization
Contact information
Practice address
1726 S BECKHAM AVE, TYLER, TX 75701-4465
(903) 593-0481
(903) 592-0555
Mailing address
1726 S BECKHAM AVE, TYLER, TX 75701-4465
(903) 593-0481
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10141004
—
TX
05
—
1782302-01
—
TX
01
—
8U0910
BCBS TX
TX
01
—
8U0912
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/20/2006
Last updated
06/05/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up