Individual
DR. TYLER VIRGIL JOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2401 S 31ST ST, OFFICE OF PODIATRY, TEMPLE, TX 76508-0001
(435) 749-3903
Mailing address
2401 S 31ST ST, OFFICE OF PODIATRY, TEMPLE, TX 76508-0001
(435) 749-3903
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
T44-2012
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
T44-2012
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T44-2012
TEXAS STATE BOARD OF PODIATRIC MEDICAL EXAMINERS
TX
Enumeration date
06/21/2012
Last updated
09/22/2014
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