TIFFANY PROVIDENCE, DO

DO

Diagnostic Radiology Physician

NPI: 1316267404IndividualAccepts Medicare

Specialties, Licenses & Credentials

Diagnostic Radiology PhysicianPrimary

Radiology — Diagnostic Radiology

Code: 2085R0202X

5101021534(MI)075202(GA)75202(GA)

General Practice Physician

General Practice

Code: 208D00000X

75202(GA)

CMS Specialties

PrimaryDIAGNOSTIC RADIOLOGY

Education

OTHER

Class of 2010

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Contact & Hours

Address: 4055 VALLEY VIEW LN STE 400
DALLAS, TX 75244
Phone: (469) 466-7420

Quick Facts

NPI: 1316267404
Entity Type: Individual
Gender: Female
Medicare: Accepted
Specialties: 4
Locations: 1
Years in Practice: 16

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