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Tiffany Lee Russell, DO
Military Health Care Provider in Dyess Afb, Texas
NPI 1811525595

Tiffany Lee Russell is a Military Health Care Provider based in Dyess Afb, TX. Tiffany Lee Russell practices in Dyess Afb, TX and has the professional credentials of DO. The NPI Number for Tiffany Lee Russell is 1811525595 and holds a License No. T2968 (Texas).

The current practice location address for Tiffany Lee Russell is 697 Louisiana Rd, Dyess Afb, TX and can be reached out via phone at 325-696-6600.

Location: 697 Louisiana Rd, Dyess Afb, TX, 79607-1141
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811525595
Provider Name
Tiffany Lee Russell
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
697 Louisiana Rd, Dyess Afb, TX, 79607-1141
Phone Number
325-696-6600
Fax Number
Provider Enumeration Date
03/30/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
697 Louisiana Rd
City
Dyess Afb
State
Texas
Zip
79607-1141
Phone Number
325-696-6600
Fax Number
person
Provider Business Mailing Address Details
Address
697 Louisiana Rd
City
Dyess Afb
State
Texas
Zip
79607-1141
Phone Number
325-696-6600
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
T2968 (Texas)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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