Individual
MR. JASON TYDLASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4509 LEMMON AVE, DALLAS, TX 75219-2145
(214) 692-6500
Mailing address
1832 CROOKED LN, FORT WORTH, TX 76112-4509
(817) 496-0749
(817) 496-0424
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
630385
TX
Other
Enumeration date
02/05/2006
Last updated
07/28/2014
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