Individual provider Active NPI

Tyler Willis, M.D.

  • Hospitalist Physician
  • Tyler, TX
National Provider Identifier
1134481914
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
P7726 Issued in TX
Practice address
800 E Dawson St
Tyler, TX 75701-2036
Phone
(903) 606-7264
NPI assigned
Jun 8, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X P7726 TX
Hospitalist Physician 208M00000X P7726 TX Primary

Addresses

Primary practice location

800 E Dawson St
Tyler, TX 75701-2036

Mailing address

2600 Saint Michael Dr Ste 340
Texarkana, TX 75503-5220

Other practice location 1

2600 Saint Michael Dr Ste 340
Texarkana, TX 75503-5220
Phone (903) 614-5111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150619001736 TX Practitioner - Family Practice 5698086478 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Texas Physician Services, PLLCGroup PAC ID 6305295429, 236 clinicians

Practice addresses (Care Compare)

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 593-8441

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P7726TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ess of Port Lavaca LLC CurrentSince Apr 1, 2018 Accepting new patients
Christus Trinity Clinic Texas CurrentSince May 2, 2022 Accepting new patients
Christus Trinity Clinic Texas Family Medicine CurrentSince May 2, 2022 Accepting new patients
Concord Medical Group PLLC CurrentSince Nov 15, 2016 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Nov 15, 2016 Accepting new patients
Memorial Hermann Medical Group Family Medicine CurrentSince Feb 1, 2021 Accepting new patients
North Texas Physician Services, PLLC Hospitalist CurrentSince Apr 1, 2024 Accepting new patients
Mother Frances Hospital Regional Health Care Center Past Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

909 Frostwood Dr
Ste 1100
Houston, TX 77024
Phone (713) 338-4523

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

400 SW 25th Ave
Mineral Wells, TX 76067
Phone (940) 325-7891

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

815 N Virginia St
Port Lavaca, TX 77979
Phone (361) 552-0325

115 Airport Rd
Sulphur Springs, TX 75482
Phone (903) 439-4052

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

2600 Saint Michael Dr
Ste 340
Texarkana, TX 75503
Phone (903) 614-5111

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Interoperability endpoints

  • Direct secure messaging: twillis280069@christushealth.direct-ci.net
  • Direct secure messaging: tyler.willis@direct.myteamcare.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1134481914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 SAINT MICHAEL DR STE 340",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755035220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E DAWSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012036",
            "telephone_number": "903-606-7264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Saint Michael Dr Ste 340",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755035220",
            "country_code": "US",
            "telephone_number": "903-614-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "TYLER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-08",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P7726",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "P7726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.