Healthcare Provider Details

I. General information

NPI: 1679798060
Provider Name (Legal Business Name): P. DENNIS DYER, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

893 NORTH IH-35 SUITE 100
ROUND ROCK TX
78664
US

IV. Provider business mailing address

893 NORTH IH-35 SUITE 100
ROUND ROCK TX
78664
US

V. Phone/Fax

Practice location:
  • Phone: 512-458-9191
  • Fax: 512-458-2330
Mailing address:
  • Phone: 512-458-9191
  • Fax: 512-458-2330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH ANN HERNANDEZ
Title or Position: PRACTICE MANAGER
Credential:
Phone: 512-458-9191