MEDICARE: DR. DYLAN LEE FORSYTHE DO

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	207L00000X	Anesthesiology Physician	W4102	TX

General Provider Information

NPI Number	:	1710626841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DYLAN LEE FORSYTHE DO

Provider Business Mailing Address
First Line	:	165 AIDEN DR
Second Line	:
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-9012
Country	:	US
Telephone Number	:	972-977-4292
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 N BECKLEY AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75203-1201
Country	:	US
Telephone Number	:	214-947-8181
Fax Number	:

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

Provider Enumeration Date	:	05/27/2022
Last Update Date	:	06/30/2026

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