Provider Demographics
NPI:1215587548
Name:DILLON, DAVID TYLER (PT, DPT, CLWT)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:TYLER
Last Name:DILLON
Suffix:
Gender:M
Credentials:PT, DPT, CLWT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 CHARLIE
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-3002
Mailing Address - Country:US
Mailing Address - Phone:903-373-1834
Mailing Address - Fax:
Practice Address - Street 1:901 CHARLIE
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791-3002
Practice Address - Country:US
Practice Address - Phone:903-373-1834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1303999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist