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1326038159

NPI Code Detail

MEDICARE: SCOTT M LIEBERMAN MD

MEDICARE: SCOTT M LIEBERMAN 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	207RC0000X	Cardiovascular Disease Physician	J6158	TX
2	207RI0011X	Interventional Cardiology Physician	J6158	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	060024159	OTHER	TX	RAIL ROAD MEDICARE

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	045166801	OTHER	TX	SMITH COUNTY INDIGENT
3	060024159	OTHER	TX	PALMETTO GBA
5	86K923	OTHER	TX	BCBS OF TEXAS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326038159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT M LIEBERMAN MD

Provider Business Mailing Address
First Line	:	1783 TROUP HWY
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75701-5869
Country	:	US
Telephone Number	:	903-595-2283
Fax Number	:	903-595-1063

Provider Business Practice Location Address
First Line	:	1783 TROUP HWY
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75701-5869
Country	:	US
Telephone Number	:	903-595-2283
Fax Number	:	903-595-1063

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	06/02/2026

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Directions to “ SCOTT M LIEBERMAN 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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