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NPI Code Detail

MEDICARE: TYLER STANNARD MD

MEDICARE:   TYLER  STANNARD  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
1207P00000XEmergency Medicine Physician0101271426VA
2390200000XStudent in an Organized Health Care Education/Training Program
3207P00000XEmergency Medicine PhysicianS4572TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710484589
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER STANNARD MD
Provider Business Mailing Address
First Line : 5323 HARRY HINES BLVD STE E4.300
Second Line :
City : DALLAS
State : TX
Zip : 75390-7208
Country : US
Telephone Number : 214-648-7207
Fax Number :
Provider Business Practice Location Address
First Line : 6201 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-1838
Country : US
Telephone Number : 214-648-3916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2018
Last Update Date : 06/30/2022

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