Individual
TIA TORTORIELLO RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7777 FOREST LN, DALLAS, TX 75230-2571
(972) 830-4342
(866) 771-0338
Mailing address
7777 FOREST LN, SUITE C-300, DALLAS, TX 75230-2571
(972) 401-8794
(866) 771-0338
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
K4816
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159169501
—
TX
05
—
159169504
—
TX
01
—
P00729257
RAILROAD MEDICARE PTAN
TX
Enumeration date
04/05/2006
Last updated
01/27/2022
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