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1225002850

NPI Code Detail

MEDICARE: HAROLD U EVERETT MD

MEDICARE: HAROLD U EVERETT 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	208000000X	Pediatrics Physician	J6424	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	370009031	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	EV082Z310	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	5598227	OTHER	TX	AETNA
7	TIN PLUS SUFFIX 027	OTHER	TX	TRICARE
8	123073	OTHER	TX	CHIPS
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	018024201	OTHER	TX	EPSDT

General Provider Information

NPI Number	:	1225002850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAROLD U EVERETT MD

Provider Business Mailing Address
First Line	:	PO BOX 846098
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-6098
Country	:	US
Telephone Number	:	903-324-6450
Fax Number	:

Provider Business Practice Location Address
First Line	:	706 TURTLE CREEK DR
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75701-1833
Country	:	US
Telephone Number	:	903-595-3942
Fax Number	:

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	08/14/2015

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Directions to “ HAROLD U EVERETT MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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