Organization
THEODORE C. DYER, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEDORE C. DYER M.D. (PRESIDENT)
(325) 676-0557
Entity
Organization
Contact information
Practice address
1904 PINE ST, SUITE 200, ABILENE, TX 79601-2449
(325) 676-0557
(866) 673-1339
Mailing address
1904 PINE ST, SUITE 200, ABILENE, TX 79601-2449
(325) 676-0557
(866) 673-1339
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
G2949
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126206506
—
TX
Enumeration date
03/23/2007
Last updated
06/20/2012
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