Provider Demographics
NPI:1205874948
Name:TWEEDY, DENNIS A (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:A
Last Name:TWEEDY
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-237-0813
Practice Address - Street 1:4101 JAMES CASEY ST
Practice Address - Street 2:SUITE 250
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1110
Practice Address - Country:US
Practice Address - Phone:512-419-9733
Practice Address - Fax:512-440-1747
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7840207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132779309Medicaid
TX8BP363OtherBCBS OF TX
TXP00691573OtherRAILROAD MEDICARE
TX132779302Medicaid
TX132779310Medicaid
TX0811853-01Medicaid
TX830004370OtherRAILROAD MEDICARE NUMBER
TXE64983Medicare UPIN
TX0080BYMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
TX132779308Medicaid
TX0811853-01Medicaid
TXP00691573OtherRAILROAD MEDICARE