Individual provider Active NPI

Julie Benell Tyler

  • Contractor
  • Dallas, TX
National Provider Identifier
1285778720
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
119785 Issued in TX
Practice address
4054 Huckleberry Cir
Dallas, TX 75216-6035
Phone
(214) 374-1206
Fax
(214) 374-0731
NPI assigned
Feb 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 119785 TX Primary

Addresses

Primary practice location

4054 Huckleberry Cir
Dallas, TX 75216-6035

Mailing address

4054 Huckleberry Cir
Dallas, TX 75216-6035
Phone (214) 374-1206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
119785TXMDContractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285778720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4054 HUCKLEBERRY CIR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752166035",
            "telephone_number": "214-374-1206",
            "fax_number": "214-374-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4054 HUCKLEBERRY CIR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752166035",
            "telephone_number": "214-374-1206",
            "fax_number": "214-374-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "JULIE",
        "middle_name": "BENELL",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "TX",
            "license": "119785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.