Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 37448 | TX |
NPI | 1386214294 |
---|---|
Provider Name | Dr. Timothy Jaryd Royer |
First Address | Nederland, TX 77627-3949 |
Second Address | Nederland, TX 77627-3949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2021 |
Last Update Date | 01/07/2021 |