Dr Lanessa D Bass, MD | |
1000 S Beckham Ave, Tyler, TX 75701-1908 | |
(903) 590-5612 | |
Not Available |
Full Name | Dr Lanessa D Bass |
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Gender | Female |
Speciality | Pediatrics |
Location | 1000 S Beckham Ave, Tyler, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982622064 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208000000X | Pediatrics | E-4425 (Arkansas) | Secondary |
208000000X | Pediatrics | M3466 (Texas) | Primary |
Entity Name | The Association Of Chrmc And University Physicians |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255449963 PECOS PAC ID: 9133032964 Enrollment ID: O20031107000585 |
Mailing Address | Practice Location Address |
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Dr Lanessa D Bass, MD 1000 S Beckham Ave, Tyler, TX 75701-1908 Ph: (903) 590-5612 | Dr Lanessa D Bass, MD 1000 S Beckham Ave, Tyler, TX 75701-1908 Ph: (903) 590-5612 |
Krystal Castle, DO Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 305 W Rusk St, Tyler, TX 75701 Phone: 903-592-7304 | |
Daniel Jun Park, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 706 Turtle Creek Dr, Tyler, TX 75701 Phone: 903-595-3942 | |
Mrs. Valerie B Smith, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1350 E Richards St, Tyler, TX 75702 Phone: 903-531-9455 Fax: 903-526-3118 | |
Ms. Yanique Tavia Ellis, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2900 North Broadway Ave, Tyler, TX 75702 Phone: 903-593-1892 | |
Kristina Orey Mitchell, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 E 5th St Ste 100, Tyler, TX 75701 Phone: 903-596-3862 Fax: 903-590-5005 | |
Adelina G. Meadows, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 706 Turtle Creek Dr, Tyler, TX 75701 Phone: 903-595-3942 | |
Dr. Michael David Austin, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 E 5th St, Tyler, TX 75701 Phone: 903-594-2450 Fax: 903-939-0610 |