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NPI Code Detail

MEDICARE: TYLER DOTY DO

MEDICARE: TYLER DOTY DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician01022081178VA

General Provider Information

NPI Number : 1023763224
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER DOTY DO
Provider Business Mailing Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : JBSA FT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 210-539-5545
Fax Number :
Provider Business Practice Location Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : JBSA FT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 210-539-5545
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2022
Last Update Date : 01/08/2026

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Directions to “ TYLER DOTY DO” Practice Location

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