Individual
TYLER D. GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4700 SETON CENTER PKWY, SUITE 200, AUSTIN, TX 78759-5295
(512) 439-1000
(512) 439-1000
Mailing address
4700 SETON CENTER PKWY, SUITE 200, AUSTIN, TX 78759-5295
(512) 439-1000
(512) 439-1128
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
L8701
TX
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
L8701
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165245502
—
TX
01
—
P00477944
MEDICARE RAILROAD
TX
Enumeration date
02/28/2006
Last updated
07/14/2020
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