Healthcare Provider Details

I. General information

NPI: 1831980721
Provider Name (Legal Business Name): DANIEL ANDREW ESTEP DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 UNIVERSITY BLVD
TYLER TX
75799-6600
US

IV. Provider business mailing address

931 RUSTIC RDG
JOPLIN MO
64804-3670
US

V. Phone/Fax

Practice location:
  • Phone: 903-566-7000
  • Fax:
Mailing address:
  • Phone: 417-437-5001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberBP10095049
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: