Provider Demographics
NPI:1417545567
Name:TYLER N. COOPER, M.D., P.A.
Entity Type:Organization
Organization Name:TYLER N. COOPER, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CLANDY
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-418-2548
Mailing Address - Street 1:1600 S COULTER ST STE 501
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-0702
Mailing Address - Country:US
Mailing Address - Phone:806-418-2548
Mailing Address - Fax:806-367-6307
Practice Address - Street 1:1600 S COULTER ST STE 501
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-0702
Practice Address - Country:US
Practice Address - Phone:806-418-2548
Practice Address - Fax:806-367-6307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty