MEDICARE: DR. TIMOTHY DOYLE CARDER 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	207Q00000X	Family Medicine Physician	S1364	TX
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1306290598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY DOYLE CARDER M.D.

Provider Business Mailing Address
First Line	:	21301 KUYKENDAHL RD STE J
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2614
Country	:	US
Telephone Number	:	713-429-0881
Fax Number	:	832-698-9568

Provider Business Practice Location Address
First Line	:	21301 KUYKENDAHL RD STE J
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2614
Country	:	US
Telephone Number	:	713-429-0881
Fax Number	:	832-698-9568

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

Provider Enumeration Date	:	04/14/2016
Last Update Date	:	05/11/2022

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