Individual
PATRICK J EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 531-4522
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
686982
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211591701
—
TX
05
—
211591702
—
TX
05
—
211591703
—
TX
01
—
75-1976930-005
TRICARE
TX
01
—
8098UA
BCBS
TX
01
—
8334UE
BCBS
TX
01
—
P01246279
RAIL ROAD
TX
01
—
TIN PLUS 015
TRICARE
TX
Enumeration date
03/04/2010
Last updated
10/13/2014
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