Individual
DR. ELI AZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 606-1914
(903) 606-1930
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M8513
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01056003A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
308048
LA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
M8513
TX
207RP1001X
Pulmonary Disease Physician
308048
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770548786
BLUE CROSS BLUE SHIELD
TX
05
—
197645801
—
TX
05
—
197645802
—
TX
01
—
P01092504
RR MEDICARE
TX
01
—
P01254126
MEDICARE RR
TX
Enumeration date
04/20/2006
Last updated
05/05/2023
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