Provider Demographics
NPI:1609665892
Name:DCTR LLYD, LLC
Entity type:Organization
Organization Name:DCTR LLYD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:BROOKES
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-317-4893
Mailing Address - Street 1:3901 S CHAMPIONS DR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8896
Mailing Address - Country:US
Mailing Address - Phone:405-317-4893
Mailing Address - Fax:
Practice Address - Street 1:300 SE D ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-6042
Practice Address - Country:US
Practice Address - Phone:405-317-4893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty