Elias I Fanous Jr MD PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

H8030 Issued in TX

Legal business name

ELIAS I FANOUS JR MD PA

Practice address

700 Olympic Plaza Cir
Suite 508
Tyler, TX 75701-1951

Phone

(903) 526-3030

NPI assigned

Jan 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Elias I Fanous Jr.NPI 1760478689

Title

Owner

Phone

(903) 526-3030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Elias I Fanous Jr., MD

  • Gastroenterology Physician
  • Tyler, TX
  • NPI 1760478689
  Medicare reassignment Care Compare group NPD Authorized official
• Aric Barrios, NP

  • Family Nurse Practitioner
  • Tyler, TX
  • NPI 1407300817
  Medicare reassignment Care Compare group NPD
• Concepcion Fanous, APRN, FNP-C

  • Family Nurse Practitioner
  • Tyler, TX
  • NPI 1366150260
  Medicare reassignment NPD

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1982880647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR",
            "address_2": "SUITE 508",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011951",
            "telephone_number": "903-526-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR",
            "address_2": "SUITE 508",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011951",
            "telephone_number": "903-526-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIAS I FANOUS JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "FANOUS",
        "authorized_official_first_name": "ELIAS",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-526-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "H8030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Uchechukwu S Elendu, MD
• Elevation Care Solutions, LLC
• Elevation Etx PLLC
• Sherif Elhanafi, MD
• Rose Elia
• Lawrence Paul Elikan, M.D.
• Elite Lab Services LLC
• Elite Primary Care
• Frances L. Elizondo, PA
• Gloria Maria Elizondo, MD

• Gastroenterology Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.