Individual
LARRY E EASTERLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-4268
(682) 885-7956
Mailing address
PO BOX 99371, FORT WORTH, TX 76199-0371
(682) 885-1855
(682) 885-7347
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
H9626
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U87Z
BCBSTX GRP PIN
TX
01
—
10032461
AMERIGROUP PIN
TX
01
—
112097100
FIRSTCARE PIN
TX
01
—
124132
SUPERIOR PIN
TX
05
—
129718605
—
TX
01
—
129718606
CSHCN
TX
01
—
1392703
UHC PIN
TX
01
—
1727198
FIRSTHEALTH PIN
TX
01
—
1750369203
GRP NPI NUMBER
—
01
—
4301822
AETNA PIN
TX
01
—
6414914
CIGNA PIN
TX
01
—
82Y892
BCBSTX IND PIN
TX
01
—
87143
PHCS PIN
TX
Enumeration date
08/30/2006
Last updated
04/04/2012
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