Individual
SCOTT M LIEBERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1783 TROUP HWY, TYLER, TX 75701-5869
(903) 595-2283
(903) 595-1063
Mailing address
1783 TROUP HWY, TYLER, TX 75701-5869
(903) 595-2283
(903) 595-1063
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
J6158
TX
207RI0011X
Interventional Cardiology Physician
Primary
J6158
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045166801
SMITH COUNTY INDIGENT
TX
05
—
045166801
—
TX
01
—
060024159
PALMETTO GBA
TX
05
—
1776475
—
LA
01
—
86K923
BCBS OF TEXAS
TX
Enumeration date
10/24/2005
Last updated
11/14/2023
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