Deberry-Carlisle, Adair

Deberry-Carlisle, Adair is an sole proprietor health care provider with primary practice located at 630 S Fleishel Ave , Tyler TX 75701-2041. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Trauma Surgery is her primary health care specialty. Deberry-Carlisle, Adair can be contacted via phone (903) 606-5560.

Contact Information

Primary practice address
630 S Fleishel Ave Tyler TX 75701-2041
Phone: (903) 606-5560
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X M0050 Texas
Allopathic & Osteopathic Physicians / Surgery 208600000X 1974 Nebraska
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 6836 Oklahoma
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 007921 Arizona
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 71035-21 Wisconsin
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 1974 Nebraska

Profile Details

NPI number 1730110651
LBN Legal business name Deberry-Carlisle, Adair
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 6th, 2006
Last updated Mar 5th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730110651 NPPES
Texas Other 8AN626 BCBSTX
Texas MEDICAID 197530202 BCBSTX
Texas MEDICAID 200908280A BCBSTX
Texas Other P02531927 BCBSTX

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