Healthcare Provider Details

I. General information

NPI: 1013603109
Provider Name (Legal Business Name): TYLER DAVID JAMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 AREA BRANCH MEDICAL CLINIC
CAMP PENDLETON CA
92055
US

IV. Provider business mailing address

2101 CHURCH ST STE 904
GALVESTON TX
77550-1869
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-3879
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberV3887
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberV3887
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: