Provider Demographics
NPI:1538698873
Name:TATSCH, TYLER NATHANIEL (MD)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:NATHANIEL
Last Name:TATSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 WINNIE ST APT 5
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-5313
Mailing Address - Country:US
Mailing Address - Phone:830-998-0608
Mailing Address - Fax:
Practice Address - Street 1:1522 WINNIE ST APT 5
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-5313
Practice Address - Country:US
Practice Address - Phone:830-998-0608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS5790207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine