Individual
BRONSON SHANE TINDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
627 TURTLE CREEK DR, TYLER, TX 75701-1832
(903) 593-2539
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3194
(817) 321-0404
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
K3944
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43848301
—
TX
Enumeration date
04/04/2006
Last updated
01/27/2022
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