Healthcare Provider Details

I. General information

NPI: 1174512156
Provider Name (Legal Business Name): BILLIE K HUFF FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 S BROADWAY AVE
TYLER TX
75701-4214
US

IV. Provider business mailing address

5012 S US HIGHWAY 75 STE 290
DENISON TX
75020-4637
US

V. Phone/Fax

Practice location:
  • Phone: 903-408-6592
  • Fax:
Mailing address:
  • Phone: 903-465-5012
  • Fax: 903-771-0270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number666909
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: