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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

Education

OTHER

Class of 2010

Contact & Hours

Address
4055 VALLEY VIEW LN STE 400
DALLAS, TX 75244

Quick Facts

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

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