OrganizationActive
Tyler Regional Hospital LLC
NPI 1063915916 · Trauma Surgery Physician · Tyler, TX
Provider details
- NPI number
- 1063915916
- Entity type
- Organization
- Primary specialty
- Trauma Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Stephen Petrovich, Evp(615) 296-3000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1000 S Beckham Ave
Tyler, TX 75701-1908
Phone: (903) 597-0351
Fax: (903) 535-6334
Street-level locationGet directions
Mailing address
1 Burton Hills Blvd Ste 250
Nashville, TN 37215-6195
Other names (DBA / former)
- Doing business as
- Ut Health East Texas Tyler Regional Hospital
Registry dates
- Enumerated
- 2018-03-16
- Last updated
- 2018-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.