Brien M Macon, | |
1000 S Beckham Ave, Tyler, TX 75701-1908 | |
(903) 531-8890 | |
Not Available |
Full Name | Brien M Macon |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 1000 S Beckham Ave, 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 |
---|---|---|---|
1396460481 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 1096163 (Texas) | Primary |
Entity Name | Northstar Anesthesia Iii Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356968952 PECOS PAC ID: 0042630501 Enrollment ID: O20201022000080 |
Mailing Address | Practice Location Address |
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Brien M Macon, 6225 N State Highway 161 Ste 200, Irving, TX 75038-2241 Ph: (214) 687-0001 | Brien M Macon, 1000 S Beckham Ave, Tyler, TX 75701-1908 Ph: (903) 531-8890 |
Mrs. Glenda R Sealey, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1424 East Front, Tyler, TX 75702 Phone: 903-595-4144 Fax: 903-596-7541 | |
John Glynn Jeansonne, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1000 S Beckham Ave, Tyler, TX 75701 Phone: 903-526-1068 Fax: 903-593-4290 | |
Jeffrey Manglicmot, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Dawson St, Tyler, TX 75701 Phone: 903-531-4522 | |
Harold Richie Bandalan, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1000 S Beckham Ave, Tyler, TX 75701 Phone: 903-526-1068 Fax: 903-593-4290 | |
Jeffrey David Barker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1000 S Beckham Ave, Tyler, TX 75701 Phone: 903-597-0351 | |
Gregory Mallett, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Dawson St, Tyler, TX 75701 Phone: 903-606-4522 | |
Cara L Dewolfe, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Dawson St, Tyler, TX 75701 Phone: 903-593-8441 |