East Texas Infectious Disease Consultants, PLLC
Internal Medicine, Infectious Disease in Tyler, TX. Organization (NPI-2).
Details
- NPI
- 1912907353
- Entity type
- Organization (NPI-2)
- Legal business name
- East Texas Infectious Disease Consultants, PLLC
- Organization subpart
- No
- Enumeration date
- Jul 28, 2005
- Last updated
- Apr 2, 2008
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RI0200X | Internal Medicine, Infectious Disease | 207R10200X | TX | Yes |
Practice location
935 S Baxter AveSte 103
Tyler, TX 75701-2245
Phone 903-592-4473 · Fax 903-592-4474
Mailing address
Po Box 131629Tyler, TX 75713-1629
Phone 903-592-4473 · Fax 903-592-4474
Authorized official
Carol Conover
Administrator
9035924473
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Infectious Disease Physician providers in Tyler, TX
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All 10 Infectious Disease Physician providers in Tyler · All 6,843 providers in Tyler
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