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NPI Code Detail

MEDICARE: DAVID BRENT TYLER

MEDICARE:   DAVID BRENT TYLER
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
1101YA0400XAddiction (Substance Use Disorder) CounselorNV

General Provider Information

NPI Number : 1528741527
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID BRENT TYLER
Provider Business Mailing Address
First Line : 323 N MARYLAND PKWY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-3130
Country : US
Telephone Number : 702-325-3330
Fax Number :
Provider Business Practice Location Address
First Line : 1529 PASTURE LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-0324
Country : US
Telephone Number : 702-561-6430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2023
Last Update Date : 08/08/2023

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Directions to “ DAVID BRENT TYLER ” Practice Location

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