Active NPI
Joseph Lynn Prud'Homme Sr., M.D.
- Specialist
- Tyler, TX
National Provider Identifier
1275571861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- D0261
- Practice address
- 1015 E Idel St
Tyler, TX 75701-2025 - Phone
- (903) 592-8301
- Fax
- (903) 592-7646
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | D0261 | TX | Primary |
Addresses
Primary practice location
1015 E Idel St
Tyler, TX 75701-2025
Mailing address
1015 E Idel St
Tyler, TX 75701-2025
Phone (903) 592-8301
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100210000323 | TX | Practitioner - General Surgery | 3678616836 | Practice locations: Tyler, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0261 | TX | MD | Specialist |
Interoperability endpoints
- jprudhomme355632@ahs.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1275571861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 E IDEL ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757012025",
"telephone_number": "903-592-8301",
"fax_number": "903-592-7646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 E IDEL ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757012025",
"telephone_number": "903-592-8301",
"fax_number": "903-592-7646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUD'HOMME",
"first_name": "JOSEPH",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "D0261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
- Sherrie Amanda Prosper, COTA
- James Carey Prosperie, RPH
- Matthew F Prosser, D.D.S.
- Prosthetic-Orthotic Associates of East Texas, Inc.
- Julie Prothro, LPC-ASSCOCIATE
- David Stephen Prudhome, CRNA
- Kelsey Pruett
- Alyssa Pruitt, M.A. CCC-SLP
- Karen Dianne Pruitt
- Psi Premier Specialties, Inc. (Medical Express, PSI)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.