Healthcare Provider Details

I. General information

NPI: 1174705883
Provider Name (Legal Business Name): DANNY L PRICE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2007
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 E RICHARDS ST
TYLER TX
75702-6153
US

IV. Provider business mailing address

1350 E RICHARDS ST
TYLER TX
75702-6153
US

V. Phone/Fax

Practice location:
  • Phone: 903-531-9455
  • Fax: 903-526-3118
Mailing address:
  • Phone: 903-531-9455
  • Fax: 903-526-3118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberJ6670
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: