Individual
DR. TYLER ALLEN WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 OAK LAWN AVE, SUITE 620, DALLAS, TX 75219-4308
(214) 642-9717
(214) 599-0366
Mailing address
3500 OAK LAWN AVE, SUITE 620, DALLAS, TX 75219-4308
(214) 642-9717
(214) 599-0366
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
L9020
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166338701
—
TX
Enumeration date
04/05/2006
Last updated
07/12/2011
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