Active NPI
Courtney Anderson
- Pathology Specialist/Technologist
- Tyler, TX
National Provider Identifier
1053972174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pathology Specialist/Technologist
- License
- 41093
- Practice address
- 9846 Hwy 31 E
Tyler, TX 75705-2329 - Phone
- (903) 592-8001
- Fax
- (903) 525-3858
- NPI assigned
- Jun 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pathology Specialist/Technologist | 246Q00000X | 41093 | TX | Primary |
Addresses
Primary practice location
9846 Hwy 31 E
Tyler, TX 75705-2329
Mailing address
9846 Hwy 31 E
Tyler, TX 75705-2329
Phone (903) 592-8001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41093 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561680000000",
"number": "1053972174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9846 HWY 31 E",
"city": "TYLER",
"state": "TX",
"postal_code": "757052329",
"telephone_number": "903-592-8001",
"fax_number": "903-525-3858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9846 HWY 31 E",
"city": "TYLER",
"state": "TX",
"postal_code": "757052329",
"telephone_number": "903-592-8001",
"fax_number": "903-525-3858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "COURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-28",
"last_updated": "2019-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "246Q00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology",
"state": "TX",
"license": "41093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.