Individual
ERIC TYLER WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2965 HARRISON ST STE 211, BEAUMONT, TX 77702-1149
(409) 899-8501
(409) 899-8510
Mailing address
PO BOX 12909, BEAUMONT, TX 77726-2909
(409) 899-8501
(409) 899-8510
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
58-001323
OH
208600000X
Surgery Physician
N4849
TX
2086S0127X
Trauma Surgery Physician
Primary
N4849
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211211201
—
TX
Enumeration date
05/23/2007
Last updated
09/19/2022
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