Organization Active NPI

Tyler Endoscopy Center, LTD

  • Ambulatory Surgical Clinic/Center
  • Tyler, TX
National Provider Identifier
1740293034
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
008143 Issued in TX
Legal business name
TYLER ENDOSCOPY CENTER, LTD
Practice address
1722 South Beckham Ave
Tyler, TX 75701
Phone
(903) 595-5101
Fax
(903) 597-2314
NPI assigned
Aug 15, 2006
Last updated
Jun 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Authorized official

Name
David Norris
Title
Administrator
Phone
(903) 595-5101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 008143 TX Primary

Addresses

Primary practice location

1722 South Beckham Ave
Tyler, TX 75701

Mailing address

1720 S Beckham Ave
Tyler, TX 75701-4464
Phone (903) 595-5101

Other identifiers 1

IdentifierTypeStateIssuer
173486501MedicaidTX

National Provider Directory

National Provider Directory

Locations

1722 S Beckham Ave
Tyler, TX 75701
Phone (903) 595-5101

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1740293034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757014464",
            "telephone_number": "903-595-5101",
            "fax_number": "903-597-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 SOUTH BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-595-5101",
            "fax_number": "903-597-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER ENDOSCOPY CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-595-5101"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "008143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173486501",
            "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 Jun 30, 2010; 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.