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Individual

DR. THEODORE C DYER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1900 PINE ST, ROOM 4653, ABILENE, TX 79601-2432
(325) 670-3500
(325) 670-4773
Mailing address
PO BOX 1198, ABILENE, TX 79604-1198
(325) 670-4220
(325) 670-4040

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G2949
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0073PJ
BLUE CROSS
TX
01
040011721
RRMEDICARE
TX
01
112066105
FIRSTCARE
TX
01
123067
SUPERIOR
TX
05
126206506
TX
Enumeration date
05/20/2006
Last updated
09/11/2014
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