Provider Demographics
NPI:1073540381
Name:DOYLE, TIMOTHY JOHN (DO)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JOHN
Last Name:DOYLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 392929
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-9900
Mailing Address - Country:US
Mailing Address - Phone:713-461-2915
Mailing Address - Fax:713-461-5307
Practice Address - Street 1:155 SCHOOL ST # 300
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-5288
Practice Address - Country:US
Practice Address - Phone:713-461-2915
Practice Address - Fax:713-461-5307
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4346207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
123807Medicare UPIN
TX863983Medicare ID - Type Unspecified