Provider Demographics
NPI:1245207638
Name:TIBILETTI, FRANCIS J (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:J
Last Name:TIBILETTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 E MARSHALL AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5597
Mailing Address - Country:US
Mailing Address - Phone:903-315-2744
Mailing Address - Fax:903-234-1339
Practice Address - Street 1:701 E MARSHALL AVE STE 309
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5597
Practice Address - Country:US
Practice Address - Phone:903-315-2744
Practice Address - Fax:903-234-1339
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4747207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00209625OtherRR MEDICARE
TX133971510Medicaid
TX133971508Medicaid
TXE91014Medicare UPIN