Organization
EAST TEXAS NEUROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHI VANCE (OFFICE MANAGER)
(903) 597-3787
Entity
Organization
Contact information
Practice address
1301 DOCTORS DR, TYLER, TX 75701-2239
(903) 597-3787
Mailing address
1301 DOCTORS DR, TYLER, TX 75701-2239
(903) 597-3787
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
D7080
TX
2084N0400X
Neurology Physician
Primary
E2095
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00ET94
BLUE CROSS
—
01
—
00P572
BLUE CROSS
—
01
—
1184652141
NPI
—
05
—
128085101
—
TX
01
—
130010459
RAILROAD MEDICARE
—
05
—
135730301
—
TX
01
—
1609803436
NPI
—
01
—
826133177
RAILROAD MEDICARE
—
Enumeration date
03/07/2012
Last updated
03/07/2012
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