Mary Lou Dene, MD | |
1402 Rice Rd Ste 100, Tyler, TX 75703-3230 | |
(903) 630-7691 | |
Not Available |
Full Name | Mary Lou Dene |
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Gender | Female |
Speciality | Internal Medicine |
Location | 1402 Rice Rd Ste 100, Tyler, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669411849 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 37811 (Kentucky) | Secondary |
207R00000X | Internal Medicine | 2005024069 (Missouri) | Secondary |
207R00000X | Internal Medicine | S4123 (Texas) | Primary |
Entity Name | Genesis Enterprises, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1730243858 PECOS PAC ID: 4082524822 Enrollment ID: O20031217000826 |
Mailing Address | Practice Location Address |
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Mary Lou Dene, MD 1402 Rice Rd Ste 100, Tyler, TX 75703-3230 Ph: (903) 630-7691 | Mary Lou Dene, MD 1402 Rice Rd Ste 100, Tyler, TX 75703-3230 Ph: (903) 630-7691 |
Ifeatu Uchenna Oti, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1133 Medical Dr, Tyler, TX 75701 Phone: 903-595-5486 Fax: 903-595-5128 | |
Preetham Reddy Muskula, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2608 Mcdonald Rd, Tyler, TX 75701 Phone: 903-595-5514 Fax: 903-262-3715 | |
Dr. Varalaxmi Bhavani Nannaka, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 912 S Fleishel Ave, Tyler, TX 75701 Phone: 903-592-6901 | |
David A Brickey, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 800 E Dawson St, Tyler, TX 75701 Phone: 903-525-1914 | |
Randy Craig Randall, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 1783 Troup Highway, Tyler, TX 75701 Phone: 903-595-2283 Fax: 903-595-1063 | |
Nabeel K Ahmed, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1133 Medical Dr, Tyler, TX 75701 Phone: 903-595-5486 Fax: 903-595-5128 | |
Rodolfo Amaro-galvez, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 11937 Us Highway 271, Tyler, TX 75708 Phone: 903-877-7072 Fax: 903-877-5838 |