MEDICARE: DR. TIMOTHY WARREN LIVENGOOD II M.D.

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	Q0106	TX

General Provider Information

NPI Number	:	1619172624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY WARREN LIVENGOOD II M.D.

Provider Business Mailing Address
First Line	:	1100 ALLIED DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-5348
Country	:	US
Telephone Number	:	469-814-3278
Fax Number	:

Provider Business Practice Location Address
First Line	:	4835 LBJ FWY STE 900
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-6001
Country	:	US
Telephone Number	:	469-420-5544
Fax Number	:

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

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	08/13/2025

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