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Organization Active NPI

Tyler Cardiovascular Consultants P.a.

  • Cardiovascular Disease Physician
  • Tyler, TX
National Provider Identifier
1376538801
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
TYLER CARDIOVASCULAR CONSULTANTS P.A.
Practice address
2608 McDonald Rd Ste 100
Tyler, TX 75701-5934
Phone
(903) 595-5514
NPI assigned
Sep 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Authorized official

Name
Thaddeus R Tolleson, M.D.
Title
President
Phone
(903) 595-5514

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X Primary
Clinical Cardiac Electrophysiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0001X
Interventional Cardiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RI0011X
Medical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AM0700X
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

2608 McDonald Rd Ste 100
Tyler, TX 75701-5934

Mailing address

2608 McDonald Rd Ste 100
Tyler, TX 75701-5934
Phone (903) 595-5514

Other identifiers 2

IdentifierTypeStateIssuer
00065KOtherTXBCBS OF TEXAS
079756501MedicaidTX

National Provider Directory

National Provider Directory

Locations

5124 North St
Nacogdoches, TX 75965
Phone (936) 560-4300

4002 S Loop 256
Ste L
Palestine, TX 75801
Phone (903) 723-0033

414 Quitman St
Pittsburg, TX 75686
Phone (903) 856-4519

800 E Dawson St
Fl 4
Tyler, TX 75701
Phone (903) 531-4080

2608 McDonald Rd
Ste 100
Tyler, TX 75701

1000 S Beckham Ave
Fl 5
Tyler, TX 75701
Phone (903) 596-3258

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437523200000",
    "number": "1376538801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 MCDONALD RD STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015934",
            "telephone_number": "903-595-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 MCDONALD RD STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015934",
            "telephone_number": "903-595-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER CARDIOVASCULAR CONSULTANTS P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2015-07-22",
        "status": "A",
        "authorized_official_last_name": "TOLLESON",
        "authorized_official_first_name": "THADDEUS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-595-5514",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "00065K",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079756501",
            "state": "TX"
        }
    ],
    "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 Jul 22, 2015; 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.