Ethan Taylor, | |
800 E Dawson St, Tyler, TX 75701-2036 | |
(903) 606-4522 | |
Not Available |
Full Name | Ethan Taylor |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 8 Years |
Location | 800 E Dawson St, Tyler, Texas |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255876348 | NPI | - | NPPES |
367663705 | Medicaid | TX | |
8LX980 | Other | TX | BCBS |
Facility Name | Location | Facility Type |
---|---|---|
Christus Mother Frances Hospital | Tyler, TX | Hospital |
Longview Regional Medical Center | Longview, TX | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Northstar Anesthesia Iii Pa | 0042630501 | 338 |
Christus Good Shepherd Medical Center | 3779565544 | 38 |
Mother Frances Hospital Regional Health Care Center | 9234025636 | 119 |
Entity Name | Longview Medical Center Lp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508824038 PECOS PAC ID: 2961490966 Enrollment ID: O20040505001835 |
Entity Name | Christus Good Shepherd Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760908404 PECOS PAC ID: 3779565544 Enrollment ID: O20040604000400 |
Entity Name | Mother Frances Hospital Regional Health Care Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679578439 PECOS PAC ID: 9234025636 Enrollment ID: O20040610001042 |
Entity Name | Main Street Anesthesia Of Texas Pa |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700381761 PECOS PAC ID: 1052675667 Enrollment ID: O20180508000762 |
Entity Name | Northstar Anesthesia Iii Pa |
---|---|
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 |
---|---|
Ethan Taylor, Po Box 841656, Dallas, TX 75284-1656 Ph: (903) 531-5000 | Ethan Taylor, 800 E Dawson St, Tyler, TX 75701-2036 Ph: (903) 606-4522 |
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 |