Provider Demographics
NPI:1790078145
Name:BILBY, ERIC NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:NEIL
Last Name:BILBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 841656
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1656
Mailing Address - Country:US
Mailing Address - Phone:903-531-5000
Mailing Address - Fax:
Practice Address - Street 1:800 E DAWSON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2036
Practice Address - Country:US
Practice Address - Phone:903-593-8441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7073207P00000X
TXBP10039807207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX336339204Medicaid
TX75-1976930-005OtherTRICARE
TX8DZ872OtherBCBS
TX336339201Medicaid
TX336339203Medicaid
TX75-26166977-028OtherTRICARE
TX75-2616977-001OtherTRICARE
TX8DZ866OtherBCBS
TX8DZ871OtherBCBS
TX75-2616977-002OtherTRICARE
TX8EB303OtherBCBS
TX336339202Medicaid
TX75-0818167-022OtherTRICARE
TX557829OtherPHYSICIAN IN TRAINING
TX8DZ871OtherBCBS
TX8EB303OtherBCBS
TX75-0818167-022OtherTRICARE
TX352624YS6VMedicare UPIN
TX336339202Medicaid
TX75-2616977-002OtherTRICARE
TX336339203Medicaid