Provider Demographics
NPI:1821303223
Name:TYLER, TOBY W (RPH)
Entity Type:Individual
Prefix:
First Name:TOBY
Middle Name:W
Last Name:TYLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 MCKINNEY PLACE DR APT 3103
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1764
Mailing Address - Country:US
Mailing Address - Phone:318-934-3692
Mailing Address - Fax:
Practice Address - Street 1:1707 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3218
Practice Address - Country:US
Practice Address - Phone:972-548-9633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA162051835P0018X
ARPD0085681835P0018X
TX386081835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist