Brianna Souder, DO in Tyler, TX - Medicare Pediatrics

Brianna Souder, DO is a medicare enrolled "Pediatrics - Pediatric Cardiology" physician in Tyler, Texas. Her current practice location is 909 E Se Loop 323 Ste 360, Tyler, Texas. You can reach out to her office (for appointments etc.) via phone at (903) 393-3169.

Brianna Souder is licensed to practice in Texas (license number V2279) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1780115618.

Contact Information

	Brianna Souder, DO
	909 E Se Loop 323 Ste 360, Tyler, TX 75701-9101
	(903) 393-3169
	(903) 508-6154

Map and Direction

Physician's Profile

Full Name	Brianna Souder
Gender	Female
Speciality	Pediatrics - Pediatric Cardiology
Location	909 E Se Loop 323 Ste 360, Tyler, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1780115618
Provider Enumeration Date: 03/22/2017
Last Update Date: 06/29/2024

Medicare PECOS Information:

PECOS PAC ID: 7517404569
Enrollment ID: I20240807004747

Medical Identifiers

Medical identifiers for Brianna Souder such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780115618	NPI	-	NPPES
2020-00828	Other	NC	NORTH CAROLINA MEDICAL BOARD
V2279	Other	TX	TEXAS MEDICAL BOARD

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	2020-00828 (North Carolina)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary
2080P0202X	Pediatrics - Pediatric Cardiology	V2279 (Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brianna Souder allows following entities to bill medicare on her behalf.

Entity Name	Dallas Physician Medical Services For Children Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1194153650 PECOS PAC ID: 1759607906 Enrollment ID: O20150305000673

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brianna Souder is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Brianna Souder, DO 909 E Se Loop 323 Ste 360, Tyler, TX 75701-9101 Ph: (903) 393-3169	Brianna Souder, DO 909 E Se Loop 323 Ste 360, Tyler, TX 75701-9101 Ph: (903) 393-3169

Reviews and Comments

Pediatrics Doctors in Tyler, TX

Krystal Castle, DO Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 305 W Rusk St, Tyler, TX 75701 Phone: 903-592-7304
Daniel Jun Park, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 706 Turtle Creek Dr, Tyler, TX 75701 Phone: 903-595-3942
Mrs. Valerie B Smith, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1350 E Richards St, Tyler, TX 75702 Phone: 903-531-9455 Fax: 903-526-3118
Ms. Yanique Tavia Ellis, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2900 North Broadway Ave, Tyler, TX 75702 Phone: 903-593-1892
Kristina Orey Mitchell, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 E 5th St Ste 100, Tyler, TX 75701 Phone: 903-596-3862 Fax: 903-590-5005
Adelina G. Meadows, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 706 Turtle Creek Dr, Tyler, TX 75701 Phone: 903-595-3942
Dr. Michael David Austin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 E 5th St, Tyler, TX 75701 Phone: 903-594-2450 Fax: 903-939-0610

Brianna Souder, DO - Medicare Pediatrics in Tyler, TX