MEDICARE: TYLER MIKLOVIC MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	T6317	TX
2	207P00000X	Emergency Medicine Physician	0101287417	VA

General Provider Information

NPI Number	:	1356900740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER MIKLOVIC MD

Provider Business Mailing Address
First Line	:	36065 SANTA FE AVE
Second Line	:
City	:	FORT HOOD
State	:	TX
Zip	:	76544-5060
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	36065 SANTA FE AVE
Second Line	:
City	:	FORT HOOD
State	:	TX
Zip	:	76544-5060
Country	:	US
Telephone Number	:	254-553-4614
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2019
Last Update Date	:	04/09/2026

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Directions to “ TYLER MIKLOVIC MD” Practice Location

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