Tyler Allen Wooten, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

L9020 Issued in TX

Practice address

3500 Oak Lawn Ave
Suite 620
Dallas, TX 75219-4308

Phone

(214) 642-9717

Fax

(214) 599-0366

NPI assigned

Apr 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tyler Wooten, MD, PLLC

  • Child & Adolescent Psychiatry Physician
  • Dallas, TX
  • NPI 1467730861
  NPD (past) Authorized official

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1821050865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 OAK LAWN AVE",
            "address_2": "SUITE 620",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194308",
            "telephone_number": "214-642-9717",
            "fax_number": "214-599-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 OAK LAWN AVE",
            "address_2": "SUITE 620",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194308",
            "telephone_number": "214-642-9717",
            "fax_number": "214-599-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "TYLER",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "L9020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166338701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard C Wootan, M.D.
• Alisha Wooten, MS CCC-SLP
• Eden Michelle Wooten, APRN, FNP-C
• Lashonda Fonta Wooten, PSY.D
• Matthew Wooten
• Dallin Wootton, PA-C
• Taylor B Wootton, MD
• Ann Word, MD
• Kathryn A Word, PT, MSPT, CBIST
• Larry Edwin Word, MD

• Child & Adolescent Psychiatry Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Child & Adolescent Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; 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.