MEDICARE: LEE E BYERLY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	L2160	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8A2658	OTHER	TX	BCBS OF TX

General Provider Information

NPI Number	:	1134128572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE E BYERLY MD

Provider Business Mailing Address
First Line	:	1501 W 11TH PL
Second Line	:	STE 200
City	:	BIG SPRING
State	:	TX
Zip	:	79720-4121
Country	:	US
Telephone Number	:	432-264-7180
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 W 11TH PL
Second Line	:	SUITE 204
City	:	BIG SPRING
State	:	TX
Zip	:	79720-4119
Country	:	US
Telephone Number	:	432-264-7180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	04/18/2016

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Directions to “ LEE E BYERLY MD” Practice Location

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