Tolleson, Thaddeus Rex

Tolleson, Thaddeus Rex is an individual health care provider with primary practice located at 619 S Fleishel Ave Suite 101, Tyler TX 75701-2004. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Tolleson, Thaddeus Rex can be contacted via phone (903) 595-5514.

Contact Information

Primary practice address
619 S Fleishel Ave Suite 101 Tyler TX 75701-2004
Phone: (903) 595-5514
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X J6770 Texas
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X J6770 Texas

Profile Details

NPI number 1912992082
LBN Legal business name Tolleson, Thaddeus Rex
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2005
Last updated Apr 26th, 2017 - about 8 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 1912992082 NPPES
Texas Other 221985502 UNITED HEALTHCARE
Texas Other 8G7380 UNITED HEALTHCARE
Texas Other 8V5491 UNITED HEALTHCARE
Texas MEDICAID 154221901 UNITED HEALTHCARE
Texas Other 7773430 UNITED HEALTHCARE

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