MEDICARE: MICHAEL EARL TYLER M.D.

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
1	207KA0200X	Allergy Physician	E7525	TX
2	207Q00000X	Family Medicine Physician	E7525	TX

General Provider Information

NPI Number	:	1053432351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL EARL TYLER M.D.

Provider Business Mailing Address
First Line	:	14615 SAN PEDRO AVE
Second Line	:	SUITE 235
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-4321
Country	:	US
Telephone Number	:	210-491-9441
Fax Number	:	210-491-9480

Provider Business Practice Location Address
First Line	:	14615 SAN PEDRO AVE
Second Line	:	SUITE 235
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-4321
Country	:	US
Telephone Number	:	210-491-9441
Fax Number	:	210-491-9480

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	09/11/2025

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