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NPI Code Detail

MEDICARE: DR. TYLER EDWARD ANTHONY DPT

MEDICARE: DR. TYLER EDWARD ANTHONY DPT
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
1225100000XPhysical Therapist1189089TX

General Provider Information

NPI Number : 1538398896
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TYLER EDWARD ANTHONY DPT
Provider Business Mailing Address
First Line : 24385 WILDERNESS OAK
Second Line : APARTMENT 7301
City : SAN ANTONIO
State : TX
Zip : 78258-7900
Country : US
Telephone Number : 919-699-7236
Fax Number :
Provider Business Practice Location Address
First Line : 5606 JEFFERSON HWY
Second Line :
City : HARAHAN
State : LA
Zip : 70123-5111
Country : US
Telephone Number : 504-733-0254
Fax Number : 504-734-8869
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2009
Last Update Date : 07/12/2011

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Directions to “ DR. TYLER EDWARD ANTHONY DPT” Practice Location

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