Individual
EDUARDO TORRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
928 N GLENWOOD BLVD, TYLER, TX 75702-5055
(903) 535-9041
Mailing address
523 S FANNIN AVE, TYLER, TX 75702-8204
(903) 535-9041
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0101237819
VA
174400000X
Specialist
P2547
TX
207V00000X
Obstetrics & Gynecology Physician
Primary
P2547
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
325156301
—
TX
01
—
45-2578435-001
TRICARE
TX
01
—
45-2578435-002
TRICARE
TX
01
—
8DS304
BCBS BLUE
TX
01
—
P01246263
MCR RAIL ROAD
TX
Enumeration date
08/31/2006
Last updated
11/21/2024
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