Healthcare Provider Details

I. General information

NPI: 1376655647
Provider Name (Legal Business Name): TLB II, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 ROUTE 134
SOUTH DENNIS MA
02660-3762
US

IV. Provider business mailing address

65 ROUTE 134
SOUTH DENNIS MA
02660-3762
US

V. Phone/Fax

Practice location:
  • Phone: 508-394-7113
  • Fax: 508-394-5470
Mailing address:
  • Phone: 508-394-7113
  • Fax: 508-394-5470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TIMOTHY L BILIOURIS
Title or Position: PRESIDENT
Credential:
Phone: 508-394-7113