Provider Demographics
NPI:1750955431
Name:NOBLE, TYLER JAMES (CPHT)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JAMES
Last Name:NOBLE
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 E OLD CHICO RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3405
Mailing Address - Country:US
Mailing Address - Phone:940-208-1638
Mailing Address - Fax:940-233-1093
Practice Address - Street 1:1308 E OLD CHICO RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3405
Practice Address - Country:US
Practice Address - Phone:940-208-1638
Practice Address - Fax:940-233-1093
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246RP1900X
TX281384183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy