Active NPI 1043252174 Individual Practitioner Male Practitioner

John Kent Campbell , FNP

Nurse Practitioner • Tyler, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

John Campbell, FNP is a certified Nurse Practitioner practicing in Tyler, TX. With approximately 25 years of clinical experience since completing medical education in 2001, John Campbell delivers high-quality medical care to the local community at 1367 DOMINION PLZ.

John Campbell is affiliated with Oliver Street 5.01(A) Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1367 Dominion Plz

Tyler, TX 757031013

Telephone 9035346200

Associated Practice Facility / Clinic

🏢 Lawrence L Anderson Md Pa Facility NPI 1932134079

Medicare Profile & Education

Medical School

Other

Graduation Year

2001

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Tyler, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

25 Yrs +15.3 yrs vs City Avg

City Avg: 9.7 Yrs

State Avg: 9.7 Yrs

Regional Practice Density

148 Specialists

Practicing in Tyler, TX (4894 Statewide)

Telehealth Adoption Rate

11.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

76.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Campbell (25 Years) 25 Yrs

Tyler Specialty Average (9.7 Years) 9.7 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
17003 Destruction of precancer skin growth, 2-14 growths	2,379	406	$23.00	$5.62
99213 Established patient office or other outpatient visit, typically 15 minutes	1,253	889	$309.00	$77.70
17000 Destruction of skin growth	646	518	$231.00	$43.02
17110 Destruction of up to 14 skin growths	531	455	$388.00	$95.34
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	423	72	$24.00	$0.98
11102 Tangential biopsy of single skin lesion	333	306	$341.00	$71.95
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	209	209	$379.00	$94.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	206	169	$435.00	$108.89
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	137	50	$49.00	$12.17
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	83	38	$23.00	$6.88
11103 Biopsy of related skin growth, each additional growth	76	54	$171.00	$42.76
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	63	58	$192.00	$48.32
11200 Removal of skin tag, 1-15 skin tags	47	43	$316.00	$56.22
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	36	36	$567.00	$140.66
11900 Injection into skin growth, 1-7 growths	36	29	$196.00	$35.89
69100 Biopsy of ear	32	27	$325.00	$62.54
17004 Destruction of precancer skin growth, 15 or more growths	31	29	$570.00	$141.81
Q0112 All potassium hydroxide (koh) preparations	30	29	$19.00	$5.71
11104 Punch biopsy, first skin growth	25	24	$425.00	$104.00
36415 Insertion of needle into vein for collection of blood sample	18	16	$10.00	$8.65
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	15	15	$608.00	$152.22
10060 Simple or single drainage of skin abscess	15	15	$433.00	$108.39
17111 Destruction of skin growth, 15 or more growths	14	13	$453.00	$112.72
99202 New patient office or other outpatient visit, typically 20 minutes	13	13	$246.00	$61.02
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	12	12	$506.00	$115.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,379	403	$23.00	$5.46
99213 Established patient office or other outpatient visit, typically 15 minutes	1,217	883	$297.00	$73.56
17000 Destruction of skin growth	617	501	$223.00	$39.12
17110 Destruction of up to 14 skin growths	544	474	$378.00	$91.31
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	490	82	$24.00	$1.06
11102 Tangential biopsy of single skin lesion	360	337	$338.00	$72.85
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	240	240	$369.00	$90.82
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	154	64	$47.00	$11.44
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	129	105	$420.00	$104.39
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	82	78	$186.00	$46.08
11103 Biopsy of related skin growth, each additional growth	63	50	$168.00	$41.12
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	46	27	$23.00	$6.67
69100 Biopsy of ear	43	41	$321.00	$60.62
11200 Removal of skin tag, 1-15 skin tags	41	41	$304.00	$57.41
17004 Destruction of precancer skin growth, 15 or more growths	34	32	$562.00	$137.85
99202 New patient office or other outpatient visit, typically 20 minutes	31	31	$238.00	$59.04
36415 Insertion of needle into vein for collection of blood sample	29	21	$10.00	$8.40
11900 Injection into skin growth, 1-7 growths	29	26	$190.00	$35.43
11104 Punch biopsy, first skin growth	27	26	$419.00	$102.87
Q0112 All potassium hydroxide (koh) preparations	27	24	$19.00	$5.71
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	25	23	$594.00	$140.36
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$547.00	$136.07
17111 Destruction of skin growth, 15 or more growths	18	18	$441.00	$108.26
10060 Simple or single drainage of skin abscess	16	16	$417.00	$102.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,052	353	$23.00	$5.67
99213 Established patient office or other outpatient visit, typically 15 minutes	1,144	836	$295.00	$74.95
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	850	146	$24.00	$1.13
17000 Destruction of skin growth	544	444	$221.00	$40.66
17110 Destruction of up to 14 skin growths	517	457	$374.00	$93.36
11102 Tangential biopsy of single skin lesion	375	353	$338.00	$73.75
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	242	108	$47.00	$11.93
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	238	220	$184.00	$46.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	209	209	$365.00	$92.54
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	197	92	$23.00	$6.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	144	111	$416.00	$106.44
11900 Injection into skin growth, 1-7 growths	65	50	$186.00	$33.49
11103 Biopsy of related skin growth, each additional growth	61	49	$169.00	$42.74
99202 New patient office or other outpatient visit, typically 20 minutes	43	43	$237.00	$60.37
10060 Simple or single drainage of skin abscess	37	34	$409.00	$103.89
17004 Destruction of precancer skin growth, 15 or more growths	35	32	$554.00	$140.87
69100 Biopsy of ear	32	29	$319.00	$66.99
36415 Insertion of needle into vein for collection of blood sample	32	26	$10.00	$2.96
11200 Removal of skin tag, 1-15 skin tags	26	26	$296.00	$56.26
Q0112 All potassium hydroxide (koh) preparations	23	23	$19.00	$5.76
11104 Punch biopsy, first skin growth	22	21	$420.00	$106.67
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$543.00	$138.38
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	17	16	$485.00	$119.80
17111 Destruction of skin growth, 15 or more growths	17	16	$437.00	$110.68
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	15	15	$587.00	$148.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,626	433	$21.14	$5.45
99213 Established patient office or other outpatient visit, typically 15 minutes	1,009	772	$289.05	$75.43
17000 Destruction of skin growth	637	538	$212.82	$39.72
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	548	101	$23.96	$1.27
17110 Destruction of up to 14 skin growths	525	460	$365.66	$92.04
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	432	369	$178.54	$46.48
11102 Tangential biopsy of single skin lesion	404	378	$335.29	$75.63
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	175	77	$46.91	$11.76
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	169	169	$358.56	$92.31
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	116	53	$22.91	$7.34
99202 New patient office or other outpatient visit, typically 20 minutes	99	99	$234.51	$60.48
11103 Biopsy of related skin growth, each additional growth	73	59	$171.04	$44.12
17004 Destruction of precancer skin growth, 15 or more growths	55	47	$530.79	$138.16
11900 Injection into skin growth, 1-7 growths	39	35	$182.00	$34.97
11200 Removal of skin tag, 1-15 skin tags	34	33	$290.00	$55.04
69100 Biopsy of ear	34	30	$320.00	$60.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	34	32	$414.00	$107.85
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	31	30	$574.79	$146.75
11104 Punch biopsy, first skin growth	28	28	$419.29	$108.66
Q0112 All potassium hydroxide (koh) preparations	28	28	$19.00	$5.83
36415 Insertion of needle into vein for collection of blood sample	26	22	$9.96	$3.00
10060 Simple or single drainage of skin abscess	22	21	$397.31	$103.04
17111 Destruction of skin growth, 15 or more growths	17	16	$428.50	$111.13
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	14	12	$479.00	$114.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,980	354	$18.18	$5.03
99213 Established patient office or other outpatient visit, typically 15 minutes	768	629	$186.39	$62.39
17000 Destruction of skin growth	501	428	$162.33	$41.05
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	379	67	$17.89	$1.46
17110 Destruction of up to 14 skin growths	352	323	$280.89	$91.46
11102 Tangential biopsy of single skin lesion	288	265	$246.89	$75.34
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	155	140	$114.85	$37.72
99202 New patient office or other outpatient visit, typically 20 minutes	151	151	$191.95	$63.28
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	147	58	$40.01	$11.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	142	139	$276.25	$90.94
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	88	38	$16.86	$6.82
17004 Destruction of precancer skin growth, 15 or more growths	44	42	$371.08	$130.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	37	37	$273.51	$89.72
11103 Biopsy of related skin growth, each additional growth	35	32	$141.70	$44.33
69100 Biopsy of ear	27	26	$238.22	$74.38
11200 Removal of skin tag, 1-15 skin tags	23	23	$220.35	$58.08
Q0112 All potassium hydroxide (koh) preparations	22	21	$15.27	$5.80
99201 New patient office or other outpatient visit, typically 10 minutes	21	21	$104.07	$38.05
11900 Injection into skin growth, 1-7 growths	21	21	$126.86	$34.91
36415 Insertion of needle into vein for collection of blood sample	20	14	$7.35	$2.99
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	19	19	$437.00	$147.78
11104 Punch biopsy, first skin growth	19	19	$314.16	$104.86
17111 Destruction of skin growth, 15 or more growths	12	11	$367.13	$109.64

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,199	367	$13.85	$4.58
99213 Established patient office or other outpatient visit, typically 15 minutes	901	675	$151.00	$60.72
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	628	117	$9.38	$1.58
17000 Destruction of skin growth	557	455	$133.00	$39.67
17110 Destruction of up to 14 skin growths	407	350	$226.00	$88.43
11102 Tangential biopsy of single skin lesion	351	325	$202.00	$71.90
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	209	179	$92.00	$36.71
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	206	86	$34.00	$13.64
99202 New patient office or other outpatient visit, typically 20 minutes	156	156	$155.00	$62.22
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	132	57	$14.00	$6.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	96	94	$221.00	$87.72
11900 Injection into skin growth, 1-7 growths	63	54	$111.00	$32.56
11103 Biopsy of related skin growth, each additional growth	60	50	$109.00	$43.21
17004 Destruction of precancer skin growth, 15 or more growths	46	40	$311.00	$124.86
J1100 Injection, dexamethasone sodium phosphate, 1 mg	46	11	$1.00	$0.10
11104 Punch biopsy, first skin growth	38	37	$254.00	$96.93
10060 Simple or single drainage of skin abscess	31	31	$243.00	$96.46
36415 Insertion of needle into vein for collection of blood sample	31	24	$6.00	$2.94
11200 Removal of skin tag, 1-15 skin tags	31	29	$181.00	$51.34
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	24	22	$296.00	$113.97
Q0112 All potassium hydroxide (koh) preparations	24	23	$12.00	$5.51
99201 New patient office or other outpatient visit, typically 10 minutes	23	23	$93.00	$37.57
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	20	19	$361.00	$141.49
69100 Biopsy of ear	20	19	$201.00	$66.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$220.00	$89.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,942	353	$37.39	$4.27
99213 Established patient office or other outpatient visit, typically 15 minutes	845	644	$105.36	$59.37
17000 Destruction of skin growth	572	463	$144.03	$38.26
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	506	90	$9.12	$1.80
17110 Destruction of up to 14 skin growths	430	371	$195.68	$89.35
11100 Biopsy of single growth of skin and/or tissue	399	362	$185.17	$76.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	244	223	$68.50	$35.64
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	151	69	$48.00	$16.69
99202 New patient office or other outpatient visit, typically 20 minutes	144	144	$116.66	$61.17
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	127	60	$23.34	$7.09
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	121	116	$156.42	$88.42
11101 Biopsy of each additional growth of skin and/or tissue	49	44	$85.65	$26.78
36415 Insertion of needle into vein for collection of blood sample	37	25	$20.57	$2.88
69100 Biopsy of ear	36	33	$196.11	$66.17
11200 Removal of skin tag, 1-15 skin tags	35	35	$151.91	$51.22
17004 Destruction of precancer skin growth, 15 or more growths	34	31	$377.20	$118.15
99201 New patient office or other outpatient visit, typically 10 minutes	34	34	$65.38	$36.34
11900 Injection into skin growth, 1-7 growths	34	33	$100.59	$33.79
Q0112 All potassium hydroxide (koh) preparations	32	28	$14.11	$5.71
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	29	27	$312.27	$122.78
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	28	28	$174.25	$88.35
10060 Simple or single drainage of skin abscess	18	18	$207.36	$97.36
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	14	13	$256.90	$109.19

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,323	414	$37.39	$4.50
99213 Established patient office or other outpatient visit, typically 15 minutes	984	755	$105.36	$58.90
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	654	114	$9.12	$1.80
17000 Destruction of skin growth	625	497	$144.03	$38.34
17110 Destruction of up to 14 skin growths	476	406	$195.68	$86.80
11100 Biopsy of single growth of skin and/or tissue	450	418	$185.17	$72.02
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	221	184	$68.50	$35.23
99202 New patient office or other outpatient visit, typically 20 minutes	200	200	$116.66	$59.89
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	177	82	$48.00	$20.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	138	127	$156.42	$87.26
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	137	63	$23.34	$6.85
11101 Biopsy of each additional growth of skin and/or tissue	80	62	$85.65	$26.34
17004 Destruction of precancer skin growth, 15 or more growths	47	45	$377.20	$121.27
Q0112 All potassium hydroxide (koh) preparations	46	42	$14.55	$5.62
99201 New patient office or other outpatient visit, typically 10 minutes	43	43	$65.38	$34.87
11900 Injection into skin growth, 1-7 growths	42	42	$100.59	$32.16
11200 Removal of skin tag, 1-15 skin tags	41	40	$151.91	$45.02
36415 Insertion of needle into vein for collection of blood sample	41	24	$20.57	$2.87
69100 Biopsy of ear	32	31	$196.11	$61.64
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	28	28	$174.25	$85.75
10060 Simple or single drainage of skin abscess	25	23	$207.36	$93.46
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	22	21	$312.27	$129.26
17111 Destruction of skin growth, 15 or more growths	12	12	$211.72	$105.83
87220 Tissue fungi or parasites	12	12	$22.00	$5.74

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License TX AP111386

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Hospital & Practice Group Affiliations

Oliver Street 5.01(A) Inc

1367 Dominion Plz, Tyler, TX 757031013

Phone: 9035346200

Oliver Street 5.01(A) Inc

317 Wilson St, Henderson, TX 756525957

Phone: 9036588707

Practice Associates & Co-Workers

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

20 Associated Practitioners

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Doctor of Medicine (M.D.)

Brit Hatch , PA-C

Physician Assistant

NPI 1073934568

Physician Assistant (Certified)

Dr. Bradley Graham , MD

Dermatology

NPI 1083641062

Doctor of Medicine (M.D.)

Dr. Alma Berlingeri Ramos , MD

Dermatology

NPI 1083818884

Doctor of Medicine (M.D.)

Dr. Elizabeth Morris , MD

Dermatology

NPI 1134156102

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

11 Historical Events

✅

NPI Profile Active August 04, 2017

NPI status registered as active in NPPES database

📍

Updated Business Mailing Address August 04, 2017

Registered at 1367 DOMINION PLAZA, TYLER, TX 75701 (Tel: 9035346200)

📍

Updated Practice Location August 04, 2017

Registered at 1367 DOMINION PLZ, TYLER, TX 757031013 (Tel: 9035346200)

👤

Provider Name / Credentials Updated August 04, 2017

Recorded as JOHN CAMPBELL, FNP

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 04, 2017

Nurse Practitioner (License #AP111386 in TX)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 1367 DOMINION PLZ, TYLER, TX 757031013 (Tel: 9035346200)

📍

Updated Business Mailing Address July 08, 2007

Registered at 3115 BROOKSIDE DR, TYLER, TX 757017705

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN CAMPBELL, NP

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Nurse Practitioner (License #FNP593914 in TX)

🟢

Initial NPI Registration & Enumeration June 12, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1043252174

Entity Type:

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

Enumeration Date: June 12, 2006

Last Update: August 04, 2017

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1367 Dominion Plaza

Tyler, TX 75701

Phone: 9035346200

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.