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General NPI Number Information
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NPI Number | 1619074846
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Entity Type | Organization
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Legal Business Name | DR H L DYER LUNG SPECIALIST, INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 11101 WHITESTONE RANCH RD
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City | BENBROOK
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State | TX
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Zip | 76126-4632
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Country | US
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Telephone | 614-371-0928
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Fax |
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Provider Business Mailing Address
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Address Line | 11101 WHITESTONE RANCH RD
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City | BENBROOK
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State | TX
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Zip | 76126-4632
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Country | US
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Telephone | 614-371-0928
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HAROLD L DYER
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Credential | D.O.
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Telephone | 614-371-0928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 34004055
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License Number State | OH
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