Healthcare Provider Details

I. General information

NPI: 1053432351
Provider Name (Legal Business Name): MICHAEL EARL TYLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14615 SAN PEDRO AVE SUITE 235
SAN ANTONIO TX
78232-4321
US

IV. Provider business mailing address

14615 SAN PEDRO AVE SUITE 235
SAN ANTONIO TX
78232-4321
US

V. Phone/Fax

Practice location:
  • Phone: 210-491-9441
  • Fax: 210-491-9480
Mailing address:
  • Phone: 210-491-9441
  • Fax: 210-491-9480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberE7525
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE7525
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: