East Texas Infusion Center, PLLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

EAST TEXAS INFUSION CENTER, PLLC

Practice address

935 S Baxter Ave
Tyler, TX 75701-2245

Phone

(903) 592-4473

Fax

(903) 592-4474

NPI assigned

Apr 18, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steven Lynn Hickreson, MD

Title

President

Phone

(903) 592-4473

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1124515879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 S BAXTER AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012245",
            "telephone_number": "903-592-4473",
            "fax_number": "903-592-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 S BAXTER AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012245",
            "telephone_number": "903-592-4473",
            "fax_number": "903-592-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS INFUSION CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "HICKRESON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-592-4473",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Texas Foot and Ankle Centers, PA
• East Texas Functional Medicine Center, LLC
• East Texas Hearing AIDS, LLC
• East Texas Home Medical and Home Modifications
• East Texas Infectious Disease Consultants, PLLC
• East Texas Lighthouse for the Blind
• East Texas LTC the Plaza at Rice Road LLC
• East Texas LTC the Waterton at Shiloh LLC
• East Texas Medical Center
• East Texas Medical Center

• Infectious Disease Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Infectious Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.