Brigham Craig Willis
MD | Pediatric Critical Care Medicine | Male
Brigham Craig Willis, MD is a Tyler, Texas based Pediatric doctor with medical specialization in
Pediatric Critical Care Medicine.
Current practice location of Brigham Craig Willis is
11937 Us Highway 271, Tyler, Texas - 75708-3154. He can be contacted on phone at
903-877-7480.
Brigham Craig Willis is a sole proprietor of his business.
NPI number (Unique professional ID) for Brigham Craig Willis is
1598701500 which was assigned by NPPES on 20 Jun, 2006 and it was last updated on 26 Jan, 2023.
Brigham Craig Willis license number is
L9556 for Pediatrics, Pediatric Critical Care Medicine (2080P0203X) in Texas.
Brigham Craig Willis is expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Complete Profile:
Brigham Craig Willis basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics, Pediatric Critical Care Medicine |
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| Provider Name : | Brigham Craig Willis |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Brigham Craig Willis address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 11937 Us Highway 271
Tyler, TX, 75708-3154
United States |
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| Phone Number : | 903-877-7480 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1598701500 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 20 Jun, 2006 |
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| Last Updated On : | 26 Jan, 2023 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Brigham Craig Willis are as mentioned. Primary taxonomy code for Brigham Craig Willis, MD is
2080P0203X (Pediatrics, Pediatric Critical Care Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | A71310 | CA |
| 2080P0203X | Pediatrics, Pediatric Critical Care Medicine | No | A71310 | CA |
| 2080P0203X | Pediatrics, Pediatric Critical Care Medicine | No | 36689 | AZ |
| 2080P0203X | Pediatrics, Pediatric Critical Care Medicine | Yes | L9556 | TX |
Legacy Identifiers:
Other legacy medical identifiers of Brigham Craig Willis such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 167824501 | MEDICAID | TX | |
| 195165 | MEDICAID | AZ | |
| 8C1881 | MEDICARE ID-Type Unspecified | TX | |
| I14412 | MEDICARE UPIN | | |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
|---|
900 UNIVERSITY AVE,
RIVERSIDE, CA, 92521-7710
United States | RIVERSIDE, CA | 951-827-7675 |
1919 E THOMAS RD,
PHOENIX, AZ, 85016-7710
United States | PHOENIX, AZ | 602-933-2311 |
3020 CHILDRENS WAY,
SAN DIEGO, CA, 92123-4223
United States | SAN DIEGO, CA | 858-966-5855 |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 11937 Us Highway 271
Tyler, TX, 75708-3154
United States |
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| Phone Number : | 903-877-7480 |
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Business Location:
Patients can refer following map for directions to
Brigham Craig Willis practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.