Provider Demographics
NPI:1184433096
Name:BILLUPS, TYMARA R
Entity type:Individual
Prefix:
First Name:TYMARA
Middle Name:R
Last Name:BILLUPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3843 LOCH LOMOND AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-2581
Mailing Address - Country:US
Mailing Address - Phone:567-322-8075
Mailing Address - Fax:
Practice Address - Street 1:3843 LOCH LOMOND AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-2581
Practice Address - Country:US
Practice Address - Phone:567-322-8075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care