Active NPI 1184649691 Individual Practitioner Male Practitioner

Dr. Sujatha Abraham White , MD

Internal Medicine • Tyler, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Sujatha White, MD is a certified Internal Medicine practicing in Tyler, TX. With approximately 30 years of clinical experience since graduating from Louisiana State University School Of Medicine In New Orleans in 1996, Dr. White delivers high-quality medical care to the local community at 1100 S BECKHAM AVE.

Dr. White is affiliated with Etmc Physician Group, Inc. and accepts Medicare assignment.

Frequently performed procedures and clinical services include chronic care management services, first, established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1100 S Beckham Ave

Tyler, TX 757013301

Telephone 9035963500

Fax 9035963536

Associated Practice Facility / Clinic

🏢 East Texas Medical Center Healthcare Associates Facility NPI 1124062484

Medicare Profile & Education

Medical School

Louisiana State University School Of Medicine In New Orleans

Graduation Year

1996

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Tyler, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

30 Yrs +8.9 yrs vs City Avg

City Avg: 21.1 Yrs

State Avg: 26.2 Yrs

Regional Practice Density

148 Specialists

Practicing in Tyler, TX (9538 Statewide)

Telehealth Adoption Rate

9.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

46.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. White (30 Years) 30 Yrs

Tyler Specialty Average (21.1 Years) 21.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	470	63	$124.73	$59.89
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	370	277	$238.00	$121.60
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	329	329	$154.00	$123.75
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	164	44	$61.00	$45.76
99213 Established patient office or other outpatient visit, typically 15 minutes	137	102	$160.00	$86.39
G0008 Administration of influenza virus vaccine	120	117	$25.00	$24.50
90662 Influenza vaccine split virus, preservative free	78	76	$70.00	$68.60
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	74	28	$100.00	$39.77
90653 Vaccine for influenza for injection into muscle	37	37	$70.00	$68.60
77080 Dxa bone density measurement of hip, pelvis, spine	37	37	$41.00	$8.99
87804 Detection test by immunoassay with direct visual observation for influenza virus	26	12	$57.00	$16.22
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	25	23	$130.00	$50.81
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$365.00	$160.45
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	23	23	$795.00	$290.48
G0009 Administration of pneumococcal vaccine	22	22	$25.00	$24.50
71046 X-ray of chest, 2 views	19	17	$68.00	$21.65
99496 Transitional care management services for problem of high complexity	18	14	$400.00	$265.35
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	15	14	$75.00	$50.28
99495 Transitional care management services for problem of at least moderate complexity	12	12	$282.00	$196.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	366	55	$125.00	$60.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	326	259	$238.00	$124.40
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	253	253	$154.00	$126.47
99213 Established patient office or other outpatient visit, typically 15 minutes	180	130	$160.00	$87.99
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	142	44	$71.70	$46.10
G0008 Administration of influenza virus vaccine	113	111	$25.00	$24.50
90662 Influenza vaccine split virus, preservative free	104	103	$70.00	$68.60
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	48	18	$100.00	$40.18
99489 Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month	36	11	$135.00	$68.36
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	31	28	$96.00	$54.99
G0009 Administration of pneumococcal vaccine	28	28	$25.00	$24.50
71046 X-ray of chest, 2 views	25	24	$66.56	$22.02
99487 Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month	18	11	$268.00	$129.11
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$239.00	$109.00
81003 Automated urinalysis test	17	17	$15.00	$2.20
99496 Transitional care management services for problem of high complexity	16	16	$400.00	$269.70
77080 Dxa bone density measurement of hip, pelvis, spine	15	15	$41.00	$9.32
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	13	12	$130.00	$50.89
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	12	12	$795.00	$282.89
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	12	12	$185.00	$130.80
93000 Routine ekg using at least 12 leads including interpretation and report	12	12	$100.00	$13.89
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$365.00	$162.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	303	253	$238.00	$123.56
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	262	262	$154.00	$126.27
99213 Established patient office or other outpatient visit, typically 15 minutes	210	156	$160.00	$87.49
G0008 Administration of influenza virus vaccine	108	107	$25.00	$24.50
77080 Dxa bone density measurement of hip, pelvis, spine	93	93	$44.59	$9.34
90662 Influenza vaccine split virus, preservative free	93	93	$70.00	$68.54
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	62	52	$96.00	$54.62
G0009 Administration of pneumococcal vaccine	35	35	$25.00	$24.69
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	30	30	$239.00	$108.17
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	23	23	$185.00	$131.67
71046 X-ray of chest, 2 views	21	19	$68.00	$22.47
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	18	18	$316.00	$161.81
99495 Transitional care management services for problem of at least moderate complexity	16	14	$282.00	$200.00
81003 Automated urinalysis test	16	16	$15.00	$2.22
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	15	15	$231.00	$161.40
90670 Pneumococcal vaccine for injection into muscle	12	12	$345.00	$248.49
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	12	11	$75.00	$50.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	329	260	$238.00	$126.60
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	213	213	$154.00	$129.51
99213 Established patient office or other outpatient visit, typically 15 minutes	197	147	$160.00	$88.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	94	78	$96.00	$54.65
G0008 Administration of influenza virus vaccine	74	74	$25.00	$16.46
90662 Influenza vaccine split virus, preservative free	62	62	$70.00	$65.26
G0009 Administration of pneumococcal vaccine	42	42	$25.00	$16.46
93000 Routine ekg using at least 12 leads including interpretation and report	29	28	$100.00	$14.37
71046 X-ray of chest, 2 views	29	27	$68.00	$22.26
G0181 Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow	29	14	$225.00	$103.24
77080 Dxa bone density measurement of hip, pelvis, spine	28	28	$41.00	$9.55
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	28	28	$185.00	$125.06
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$239.00	$109.49
36415 Insertion of needle into vein for collection of blood sample	26	25	$20.00	$3.00
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$365.00	$162.25
81002 Urinalysis, manual test	21	20	$20.00	$3.48
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	17	12	$100.00	$39.96
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	16	16	$316.00	$164.46
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	16	12	$41.00	$13.84
99495 Transitional care management services for problem of at least moderate complexity	15	15	$282.00	$201.41
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	14	14	$130.00	$51.56
90670 Pneumococcal vaccine for injection into muscle	14	14	$345.00	$240.58
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	13	13	$110.00	$66.43
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	11	11	$231.00	$164.80

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	282	197	$160.00	$71.17
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	264	221	$238.00	$106.07
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	226	226	$154.00	$114.29
93000 Routine ekg using at least 12 leads including interpretation and report	157	154	$100.00	$16.61
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	100	86	$96.00	$43.07
77080 Dxa bone density measurement of hip, pelvis, spine	71	71	$41.00	$9.91
G0008 Administration of influenza virus vaccine	60	58	$25.00	$16.19
G0009 Administration of pneumococcal vaccine	59	59	$25.00	$16.15
81002 Urinalysis, manual test	39	32	$20.00	$3.46
36415 Insertion of needle into vein for collection of blood sample	39	35	$20.00	$2.98
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	35	35	$102.80	$61.00
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	33	33	$185.00	$118.47
99495 Transitional care management services for problem of at least moderate complexity	31	28	$282.00	$179.27
71046 X-ray of chest, 2 views	31	30	$68.00	$20.81
90670 Pneumococcal vaccine for injection into muscle	26	26	$345.00	$225.21
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	26	24	$40.00	$19.40
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	26	17	$100.00	$39.24
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	24	24	$316.00	$168.38
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$365.00	$161.83
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	21	17	$130.00	$52.07
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	17	17	$231.00	$163.86
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	14	13	$41.00	$13.96

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	371	225	$160.00	$71.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	270	207	$238.00	$105.66
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	186	186	$154.00	$112.80
93000 Routine ekg using at least 12 leads including interpretation and report	155	148	$100.00	$16.47
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	130	104	$96.00	$43.40
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	91	91	$316.00	$167.70
G0009 Administration of pneumococcal vaccine	75	74	$25.00	$15.90
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	55	25	$98.18	$39.98
G0008 Administration of influenza virus vaccine	54	50	$25.00	$15.90
90662 Influenza vaccine split virus, preservative free	41	39	$70.00	$53.88
71046 X-ray of chest, 2 views	40	38	$68.00	$19.52
36415 Insertion of needle into vein for collection of blood sample	40	35	$20.00	$2.94
81002 Urinalysis, manual test	39	33	$20.00	$3.41
90670 Pneumococcal vaccine for injection into muscle	38	38	$333.63	$209.18
99495 Transitional care management services for problem of at least moderate complexity	32	23	$282.00	$159.82
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	29	29	$175.34	$110.40
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$365.00	$160.52
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	26	24	$130.00	$51.82
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$239.00	$105.34
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	21	21	$231.00	$161.13
77080 Dxa bone density measurement of hip, pelvis, spine	20	20	$41.00	$9.83
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	14	13	$29.57	$15.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	646	359	$20.00	$2.92
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	553	314	$238.00	$102.44
99213 Established patient office or other outpatient visit, typically 15 minutes	436	244	$160.00	$69.78
G0008 Administration of influenza virus vaccine	134	131	$25.00	$19.51
90653 Vaccine for influenza for injection into muscle	111	109	$70.00	$53.07
93000 Routine ekg using at least 12 leads including interpretation and report	104	101	$100.00	$16.13
G0009 Administration of pneumococcal vaccine	61	58	$25.00	$19.51
J1100 Injection, dexamethasone sodium phosphate, 1 mg	60	14	$12.00	$0.12
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	60	14	$10.00	$1.81
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	58	55	$96.00	$42.27
71046 X-ray of chest, 2 views	58	55	$64.07	$18.27
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	42	42	$154.00	$112.32
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	36	17	$100.00	$40.05
G0181 Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow	32	17	$225.00	$105.25
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	32	31	$130.00	$51.73
81002 Urinalysis, manual test	32	26	$20.00	$3.30
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	31	31	$365.00	$159.35
90670 Pneumococcal vaccine for injection into muscle	31	31	$297.00	$199.04
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	27	27	$150.00	$105.59
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	25	21	$24.80	$19.67
81003 Automated urinalysis test	16	16	$15.00	$2.71
90662 Influenza vaccine split virus, preservative free	11	11	$68.73	$51.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
36415 Insertion of needle into vein for collection of blood sample	660	367	$20.00	$2.93
99213 Established patient office or other outpatient visit, typically 15 minutes	538	281	$132.35	$69.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	402	250	$200.10	$102.08
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	194	140	$85.55	$41.37
G0008 Administration of influenza virus vaccine	151	146	$25.00	$23.91
G0181 Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow	138	27	$225.00	$103.94
90653 Vaccine for influenza for injection into muscle	117	117	$70.00	$49.22
71020 X-ray of chest, 2 views, front and side	83	72	$95.01	$15.72
J0696 Injection, ceftriaxone sodium, per 250 mg	68	15	$25.00	$0.64
G0009 Administration of pneumococcal vaccine	66	65	$25.00	$23.91
J1100 Injection, dexamethasone sodium phosphate, 1 mg	64	16	$12.00	$0.11
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	61	16	$10.00	$1.79
81002 Urinalysis, manual test	57	44	$20.00	$3.31
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	47	47	$154.00	$110.49
93000 Routine ekg using at least 12 leads including interpretation and report	46	43	$100.00	$15.40
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	41	41	$150.00	$95.17
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	35	32	$25.00	$24.06
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	34	34	$314.26	$154.19
90670 Pneumococcal vaccine for injection into muscle	25	25	$297.00	$186.07
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	20	20	$40.00	$18.65
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	18	17	$130.00	$48.53
90662 Influenza vaccine split virus, preservative free	14	14	$56.00	$41.87
87804 Detection test by immunoassay with direct visual observation for influenza virus	14	13	$57.00	$16.11
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$216.85	$103.60

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License TX K1329

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Hospital & Practice Group Affiliations

Etmc Physician Group, Inc.

2210 Three Lakes Pkwy, Tyler, TX 757030642

Phone: 9037474050

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners

David Hardy , FNP-C

Nurse Practitioner - Family

NPI 1083149397

Family Nurse Practitioner (Certified)

Dr. Katherine Root , MD

Internal Medicine

NPI 1083932818

Doctor of Medicine (M.D.)

Dr. Stephen Rydzak , MD

Internal Medicine

NPI 1184656555

Doctor of Medicine (M.D.)

Dr. Natalie Johnson , MD

Internal Medicine

NPI 1356351977

Doctor of Medicine (M.D.)

Dr. Cory Cummings , MD

Family Medicine

NPI 1366821928

Doctor of Medicine (M.D.)

Dr. Nghia Truong , MD

Internal Medicine

NPI 1407876626

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active November 02, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location November 02, 2007

Registered at 1100 S BECKHAM AVE, TYLER, TX 757013301 (Tel: 9035963500)

📍

Updated Business Mailing Address November 02, 2007

Registered at PO BOX 9477, TYLER, TX 757119477 (Tel: 9035942450)

👤

Provider Name / Credentials Updated November 02, 2007

Recorded as SUJATHA WHITE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 02, 2007

Internal Medicine (License #K1329 in TX)

🟢

Initial NPI Registration & Enumeration July 13, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1184649691

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 13, 2006

Last Update: November 02, 2007

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 9477

Tyler, TX 757119477

Phone: 9035942450

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.