Gregory Mallett, | |
800 E Dawson St, Tyler, TX 75701 | |
(903) 606-4522 | |
Not Available |
Full Name | Gregory Mallett |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 13 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 |
---|---|---|---|
1093085193 | NPI | - | NPPES |
75-2771569-008 | Other | TX | TRICARE |
8683UK | Other | TX | BCBS |
P02245621 | Other | TX | MEDICARE RAIL ROAD |
314440403 | Medicaid | TX | |
314440406 | Other | TX | MEDICARE |
8JM831 | Other | TX | BCBS |
799488 | Other | TX | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | RN117800 (Louisiana) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 826622 (Texas) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Christus Mother Frances Hospital | Tyler, TX | Hospital |
University Health System | San antonio, TX | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Community Medicine Associates | 7719979509 | 397 |
Mother Frances Hospital Regional Health Care Center | 9234025636 | 119 |
Entity Name | Community Medicine Associates |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245313329 PECOS PAC ID: 7719979509 Enrollment ID: O20040401000372 |
Entity Name | Mother Frances Hospital Jacksonville |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952306672 PECOS PAC ID: 5597751024 Enrollment ID: O20040421001092 |
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 | University Of Texas Health Science Center At San Antonio |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720051717 PECOS PAC ID: 0042128548 Enrollment ID: O20040607000664 |
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 |
Mailing Address | Practice Location Address |
---|---|
Gregory Mallett, Po Box 841656, Dallas, TX 75284-1656 Ph: () - | Gregory Mallett, 800 E Dawson St, Tyler, TX 75701 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 | |
Cara L Dewolfe, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Dawson St, Tyler, TX 75701 Phone: 903-593-8441 |