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Individual

MS. AMY C SPROLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 593-8441
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 606-6400
(903) 606-1522

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA08812
TX
364SE0003X
Emergency Clinical Nurse Specialist
PA130028
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
338953803
TX
05
338953804
TX
05
338953805
TX
05
338953806
TX
01
75-0818167-015
TRICARE
TX
01
75-0818167-022
TRICARE
TX
01
75-0818167-044
TRICARE
TX
01
75-0818167-048
TRICARE
TX
01
75-1976930-005
TRICARE
TX
01
75-2616977-001
TRICARE
TX
01
75-2616977-002
TRICARE
TX
01
75-2616977-028
TRICARE
TX
01
8984NM
BCBS
TX
01
8985NM
BCBS
TX
01
8986NM
BCBS
TX
01
8987NM
BCBS
TX
01
P01429137
MEDICARE RAIL ROAD
TX
01
P01429303
MEDICARE RAIL ROAD
TX
01
P01433269
RAIL ROAD MEDICARE
TX
Enumeration date
06/08/2006
Last updated
04/22/2026
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