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HAROLD U EVERETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
706 TURTLE CREEK DR, TYLER, TX 75701-1833
(903) 595-3942
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J6424
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
018024201
EPSDT
TX
01
123073
CHIPS
TX
05
135158705
TX
05
135158710
TX
05
135158711
TX
05
135158712
TX
01
370009031
MEDICARE RAILROAD
TX
01
5598227
AETNA
TX
01
EV082Z310
BCBS
TX
01
TIN PLUS SUFFIX 027
TRICARE
TX
Enumeration date
02/13/2006
Last updated
08/14/2015
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