Provider Demographics
NPI:1982348223
Name:ARCEMENT, TYLER (PTA)
Entity Type:Individual
Prefix:MR
First Name:TYLER
Middle Name:
Last Name:ARCEMENT
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 GRAND AVENUE PKWY APT 14207
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-4810
Mailing Address - Country:US
Mailing Address - Phone:407-620-2568
Mailing Address - Fax:
Practice Address - Street 1:6150 OAKMONT TRL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-2841
Practice Address - Country:US
Practice Address - Phone:817-292-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2168684225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant