Healthcare Provider Details

I. General information

NPI: 1720440431
Provider Name (Legal Business Name): SCOTT JEFFREY TLANDA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11016 AMELINA LN
FRISCO TX
75035-7679
US

IV. Provider business mailing address

11016 AMELINA LN
FRISCO TX
75035-7679
US

V. Phone/Fax

Practice location:
  • Phone: 972-310-2106
  • Fax:
Mailing address:
  • Phone: 972-310-2106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberS1935
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01098396A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberS1935
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number01098396A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: