NPI Code Details Logo

NPI 1538550595

NPI 1538550595 : DAVLYN TILLMAN M.D. : HOUSTON, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1538550595
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    DAVLYN TILLMAN M.D.
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/12/2015
-----------------------------------------------------
    Last Update Date     |    08/16/2024
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1504 TAUB LOOP 
-----------------------------------------------------
    City                 |    HOUSTON
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    77030-1608
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    713-873-8890
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1 BAYLOR PLZ # 2GR900 
-----------------------------------------------------
    City                 |    HOUSTON
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    77030-3411
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    713-798-1750
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    208000000X
-----------------------------------------------------
    Taxonomy Name        |    Pediatrics Physician
-----------------------------------------------------
    License Number       |    T3202
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    208000000X
-----------------------------------------------------
    Taxonomy Name        |    Pediatrics Physician
-----------------------------------------------------
    License Number       |    125.067550
-----------------------------------------------------
    License Number State |    IL
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.