Active NPI
Matthew Brousseau
- Certified Registered Nurse Anesthetist
- Tyler, TX
National Provider Identifier
1942161773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 1019942
- Practice address
- 1000 S Beckham Ave
Tyler, TX 75701-1908 - Phone
- (903) 597-0351
- NPI assigned
- Nov 20, 2025
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1019942 | TX | Primary |
Addresses
Primary practice location
1000 S Beckham Ave
Tyler, TX 75701-1908
Mailing address
10382 Holly Creek Rd
Terrell, TX 75160-8837
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1763596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788480000000",
"number": "1942161773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10382 HOLLY CREEK RD",
"city": "TERRELL",
"state": "TX",
"postal_code": "751608837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 S BECKHAM AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757011908",
"telephone_number": "903-597-0351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUSSEAU",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-20",
"last_updated": "2026-09-04",
"certification_date": "2026-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "1019942",
"primary": true
}
],
"identifiers": [],
"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 Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.