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NPI Code Detail

MEDICARE: DAVID W. TYBOR O.D.

MEDICARE:   DAVID W. TYBOR  O.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
1152W00000XOptometrist3233TGTX

General Provider Information

NPI Number : 1912064957
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID W. TYBOR O.D.
Provider Business Mailing Address
First Line : 6000 W WILLIAM CANNON DR
Second Line : BLDG. A, SUITE 100
City : AUSTIN
State : TX
Zip : 78749-1975
Country : US
Telephone Number : 512-288-0444
Fax Number : 512-288-1009
Provider Business Practice Location Address
First Line : 6000 W WILLIAM CANNON DR
Second Line : BLDG. A, SUITE 100
City : AUSTIN
State : TX
Zip : 78749-1975
Country : US
Telephone Number : 512-288-0444
Fax Number : 512-288-1009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2007
Last Update Date : 10/04/2023

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Directions to “ DAVID W. TYBOR O.D.” Practice Location

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