Jeffrey Manglicmot, CRNA | |
800 E Dawson St, Tyler, TX 75701-2036 | |
(903) 531-4522 | |
Not Available |
Full Name | Jeffrey Manglicmot |
---|---|
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 |
---|---|---|---|
1043758162 | NPI | - | NPPES |
P01815493 | Other | TX | MEDICARE RAIL ROAD |
75-0818167-015 | Other | TX | TRICARE |
8671UP | Other | TX | BCBS |
369478801 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | AP133234 (Texas) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Christus Mother Frances Hospital | Tyler, TX | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mother Frances Hospital Regional Health Care Center | 9234025636 | 119 |
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 |
---|---|
Jeffrey Manglicmot, CRNA Po Box 841656, Dallas, TX 75284-1656 Ph: (903) 531-5000 | Jeffrey Manglicmot, CRNA 800 E Dawson St, Tyler, TX 75701-2036 Ph: (903) 531-4522 |
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 | |
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 |