MEDICARE: TYMES HEALTH CARE

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	122300000X	Dentist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21579	OTHER	TX	LICENSE DENTAL

General Provider Information

NPI Number	:	1932673423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TYMES HEALTH CARE

Provider Business Mailing Address
First Line	:	3440 RILEY FUZZEL RD STE 200
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-4189
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3440 RILEY FUZZEL RD STE 200
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-4189
Country	:	US
Telephone Number	:	832-652-7330
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JENNIE THORNTON
Credential	:
Telephone Number	:	832-652-7330

Provider Enumeration Date	:	01/17/2019
Last Update Date	:	01/17/2019

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Directions to “TYMES HEALTH CARE ” Practice Location

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