Provider Demographics
NPI:1629063953
Name:DYER, JOEL EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:EDWARD
Last Name:DYER
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 1:3405 FELDSPAR LN
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-2404
Mailing Address - Country:US
Mailing Address - Phone:432-699-2303
Mailing Address - Fax:
Practice Address - Street 1:2706 W CUTHBERT AVE
Practice Address - Street 2:BUILDING B, STE. 100
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-3885
Practice Address - Country:US
Practice Address - Phone:432-699-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17529174400000X
TXF9385207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered174400000XOther Service ProvidersSpecialist
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology