Provider Demographics
NPI:1295913150
Name:TYLER, AMY KATHRYN (ND)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:KATHRYN
Last Name:TYLER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 LOMITA VERDE CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-4203
Mailing Address - Country:US
Mailing Address - Phone:512-669-1374
Mailing Address - Fax:
Practice Address - Street 1:9901 BRODIE LN STE NO1021
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5803
Practice Address - Country:US
Practice Address - Phone:512-607-4321
Practice Address - Fax:512-607-4321
Is Sole Proprietor?:No
Enumeration Date:2008-02-03
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0073455175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath