Provider Demographics
NPI:1457587933
Name:HOPE, TARYN (PA-C)
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:HOPE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5777 NEW COPELAND RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3905
Mailing Address - Country:US
Mailing Address - Phone:903-561-9255
Mailing Address - Fax:
Practice Address - Street 1:5777 NEW COPELAND RD STE 100
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-3905
Practice Address - Country:US
Practice Address - Phone:903-561-9255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05351363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8KF038OtherBCBS
TXP02137098OtherMEDICARE RAIL ROAD
TX359525803Medicaid
TX8KF039OtherBCBS
TXP02136994OtherMEDICARE RAIL ROAD
TX359525802Medicaid
TX730050OtherMEDICARE
TX730053OtherMEDICARE