Healthcare Provider Details

I. General information

NPI: 1740869700
Provider Name (Legal Business Name): TYLER JAMES NOVY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5516 LOCKWOOD DR
HOUSTON TX
77026-1919
US

IV. Provider business mailing address

6431 FANNIN ST # 3.151
HOUSTON TX
77030-1501
US

V. Phone/Fax

Practice location:
  • Phone: 713-497-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax: 713-500-5800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberU9043
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: