BRIGHAM CRAIG WILLIS MD NPI 1598701500

NPI Information

  • NPI: 1598701500
  • Provider Name: BRIGHAM CRAIG WILLIS, MD
  • Classification: Pediatrics - 2080P0203X
  • Specialization: Pediatric Critical Care Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 11937 US HIGHWAY 271
    TYLER, TX
    ZIP 75708
  • Phone: (903) 877-7480

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NPI Details

Brigham Craig Willis, MD is a pediatric critical care medicine pediatrics in Tyler, TX. The provider is a pediatrician 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. Brigham Craig Willis, MD NPI is 1598701500. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11937 US HIGHWAY 271
TYLER, TX
ZIP 75708-154
Phone: (903) 877-7480

The NPI 1598701500 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/20/2006 and was last updated on 11/7/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0203XPediatricsPediatric Critical Care MedicineL9556TEXASYes
2208000000XPediatricsA71310CALIFORNIANo
32080P0203XPediatricsPediatric Critical Care MedicineA71310CALIFORNIANo
42080P0203XPediatricsPediatric Critical Care Medicine36689ARIZONANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1167824501MEDICAIDTEXAS
2195165MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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