Kimberly S Tyner, MD | |
2504 Ridge Rd, Suite 201, Rockwall, TX 75087-2569 | |
(972) 722-5959 | |
(972) 722-5538 |
Full Name | Kimberly S Tyner |
---|---|
Gender | Female |
Speciality | Obstetrics & Gynecology |
Location | 2504 Ridge Rd, Rockwall, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306959432 | NPI | - | NPPES |
160462101 | Medicaid | TX | |
100512421 | Medicaid | NV | |
00864T | Other | TX | MEDICARE GROUP PTAN |
160462102 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | L5594 (Texas) | Primary |
Entity Name | Pediatrix Medical Group Of Texas Billing Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649377359 PECOS PAC ID: 0042283921 Enrollment ID: O20110907001264 |
Mailing Address | Practice Location Address |
---|---|
Kimberly S Tyner, MD Po Box 871, Terrell, TX 75160-0017 Ph: (972) 722-5959 | Kimberly S Tyner, MD 2504 Ridge Rd, Suite 201, Rockwall, TX 75087-2569 Ph: (972) 722-5959 |
Mr. Thomas Stephen Sudela, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 2504 Ridge Road, Suite 201, Rockwall, TX 75087 Phone: 972-722-0404 Fax: 972-722-7082 | |
Dr. Michael W Cowart, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 6617 Heritage Pkwy, Suite 100, Rockwall, TX 75087 Phone: 972-475-3030 Fax: 972-475-0707 | |
Mrs. Reba K Rollinson, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 306 Victory Lane, Terrell Womens Health Center, Rockwall, TX 75032 Phone: 214-207-0551 | |
Carol A. Poole, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 901 Rockwall Pkwy, Rockwall, TX 75032 Phone: 972-772-3234 Fax: 972-772-3834 | |
Jewell E. Malick, D.O. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 901 Rockwall Pkwy, Rockwall, TX 75032 Phone: 972-772-3234 Fax: 972-772-3834 | |
Dr. Theresa Conyac, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 6705 Heritage Parkway, Suite 102, Rockwall, TX 75087 Phone: 972-722-2526 Fax: 972-722-2528 |