Individual
DR. LINDA JEAN ROYALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19222 STONEHUE, STE 103, SAN ANTONIO, TX 78258-3454
(210) 497-1475
(210) 497-1502
Mailing address
1367 DOMINION PLZ, TYLER, TX 75703-1013
(903) 564-6200
(903) 939-0755
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G4925
TX
207N00000X
Dermatology Physician
Primary
G4925
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8FB111
BCBS PV#
TX
Enumeration date
05/27/2005
Last updated
08/04/2015
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