Individual
ERIC JEFFREY LA VOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3953 E GRANDE BLVD, TYLER, TX 75707-1401
(903) 839-2585
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R-9539
IA
207Q00000X
Family Medicine Physician
Primary
R0054
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75-2616977-129
TRICARE
TX
01
—
8GM862
BCBS
TX
01
—
P01812204
RAIL ROAD MEDICARE
TX
Enumeration date
06/27/2012
Last updated
03/17/2022
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