Organization
EAST TEXAS NEPHROLOGY ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOLLY MAE BANKHEAD M.D. (PRESIDENT)
(903) 526-6374
Entity
Organization
Contact information
Practice address
700 S FLEISHEL AVE, TYLER, TX 75701-2014
(903) 526-6374
(903) 526-4578
Mailing address
700 S FLEISHEL AVE, TYLER, TX 75701-2014
(903) 526-6374
(903) 526-4578
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H8527
TX
174400000X
Specialist
H9769
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0086HD
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/20/2006
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us