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General NPI Number Information
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NPI Number | 1396616645
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Entity Type | Individual
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Provider Name | TIFFANY RENE DILLARD
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Gender | Female
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 539 W COMMERCE ST # 3832
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City | DALLAS
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State | TX
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Zip | 75208-1953
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Country | US
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Telephone | 832-446-1556
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Fax | 832-626-2131
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Provider Business Mailing Address
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Address Line | 539 W COMMERCE ST # 3832
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City | DALLAS
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State | TX
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Zip | 75208-1953
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Country | US
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Telephone | 832-446-1556
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Fax | 832-626-2131
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | TX
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