Basic Information
| Provider Information | |||||||||
| NPI: | 1356846570 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | TYLER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1441 N BECKLEY AVE | ||||||||
| Address2: | ATTN DMPN | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2149472385 | ||||||||
| FaxNumber: | 2149472390 | ||||||||
| Practice Location | |||||||||
| Address1: | 1441 N BECKLEY AVE | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752031201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2149478181 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2018 | ||||||||
| LastUpdateDate: | 12/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 238691 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.