R Kent Vandergriff
Nurse Practitioner - Critical Care Medicine
800 E Dawson St
Tyler
, Texas 75701-2036
R Kent Vandergriff
Nurse Practitioner - Critical Care Medicine
800 E Dawson St
Tyler
, Texas 75701-2036
(903) 531-5000
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About
Features
Specialties
- Nurse Practitioner - Critical Care Medicine
Languages spoken
- English
Location
First Address
- R Kent Vandergriff
- Po Box 841656
- Dallas, TX
- Zip : 75284-1656
- Phone : (903) 531-5000
Second Address
- R Kent Vandergriff
- 800 E Dawson St
- Tyler, TX
- Zip : 75701-2036
- Phone : (903) 525-1914
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 631043 | TX |
National Provider Identifier
| NPI | 1215230586 |
|---|---|
| Provider Name | R Kent Vandergriff |
| First Address | Dallas, TX 75284-1656 |
| Second Address | Tyler, TX 75701-2036 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/12/2010 |
| Last Update Date | 14/10/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 280002101 | (05) | TX |
| 835N41 | BCBS (01) | TX |
| TIN PLUS 042 | TRICARE (01) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.