Individual
BRIGHAM CRAIG WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-7480
Mailing address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-7480
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A71310
CA
2080P0203X
Pediatric Critical Care Medicine Physician
36689
AZ
2080P0203X
Pediatric Critical Care Medicine Physician
A71310
CA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
L9556
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167824501
—
TX
05
—
195165
—
AZ
Enumeration date
06/20/2006
Last updated
11/07/2024
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