Madore, Eric S

Madore, Eric S is an individual health care provider with primary practice located at 800 E Dawson St , Tyler TX 75701-2036. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Madore, Eric S can be contacted via phone (903) 510-1186.

Contact Information

Primary practice address
800 E Dawson St Tyler TX 75701-2036
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X L8117 Texas

Profile Details

NPI number 1982678884
LBN Legal business name Madore, Eric S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated May 12th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982678884 NPPES
Texas Other TIN PLUS 042 TRICARE
Texas MEDICAID 164585502 TRICARE
Texas Other 8J1055 TRICARE

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