MS. VICTORIA LYNN TYRA (NPI# 1164679510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164679510 |
| Entity Type | Individual |
| Full Name | MS. VICTORIA LYNN TYRA |
| Credential | RN, FNP-C |
| Practice Address |
270 Abner Jackson Pkwy Lake Jackson TX 77566-5124 |
| Mailing Address |
516 Park Ln Richardson TX 75081-4246 |
| Practice Telephone | 9794305440 |
| Mailing Telephone | 9729779421 |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2019-02-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP117203 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 308376801 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1254 Enclave Pkwy, Houston, TX 770772564 | 8882258097 | |
| 2019 N Interstate 35 E, Desoto, TX 751152688 | 2109547614 | |
| 1600 N Business 45, Corsicana, TX 751102713 | 9036414327 |
| Street Address |
270 ABNER JACKSON PKWY |
| City | LAKE JACKSON |
| State | TX |
| Zip Code | 77566-5124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912378431 | Quad/med, LLC | Pharmacy | 270 Abner Jackson Pkwy, Lake Jackson, TX 77566-5124 | 2015-10-09 |
| 1487048203 | Medical Care Innovation, P.C. | Clinic/Center | 270 Abner Jackson Pkwy, Lake Jackson, TX 77566-5124 | 2015-03-19 |
| 1245677087 | Erin Elizabeth Waybright | Nurse Practitioner | 270 Abner Jackson Pkwy, Lake Jackson, TX 77566-5124 | 2013-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588271746 | Daniel Kent | Pharmacist | 121 Tx-332 W, Lake Jackson, TX 77566 | 2020-09-30 |
| 1134692403 | Gulf Coast Gastroenterology Lab | Clinical Medical Laboratory | 219 Oak Drive South, Suite A, Lake Jackson, TX 77566 | 2019-01-09 |
| 1194266288 | Kaitlin Dingee | Nurse Practitioner | 208 Oak Dr S Ste 502, Lake Jackson, TX 77566 | 2017-03-09 |
| 1326581935 | Nec Lake Jackson Emergency Center, Lp | Clinic/Center | 103 Winding Way, Lake Jackson, TX 77566 | 2016-11-30 |
| 1548618911 | Sara Eddy | Counselor | 109 Circle Way, Lake Jackson, TX 77566 | 2016-05-26 |
| 1689020158 | Baker Chiropractic Center Pllc | Chiropractor | 100-a Plantation Drive, Lake Jackson, TX 77566 | 2016-05-13 |
| 1326409368 | Janet Chen | Pharmacist | 131 Oyster Creek Dr., Lake Jackson, TX 77566 | 2016-03-18 |
| 1164819488 | Eco Dental Care, Pllc | Dentist | 210 Lake Rd, Ste 800 A, Lake Jackson, TX 77566 | 2015-04-24 |
| 1730578196 | Anna Katherine Tucker | Occupational Therapy Assistant | 1052 Cardinal Dr, Richwood, TX 77566 | 2015-01-22 |
| 1306243035 | H-e-b, Lp | Clinical Medical Laboratory | 97 Oyster Creek Drive, Lake Jackson, TX 77566 | 2014-11-24 |
| Find all providers in zip 77566 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245736388 | Stevani Crowley | Nurse Practitioner | 75 Staghorn Ct, Lake Jackson, TX 77566-4166 | 2018-04-05 |
| 1316459704 | Samantha Denea Gonzalez | Nurse Practitioner | 201 Oak Dr S Ste 203, Lake Jackson, TX 77566-5627 | 2017-10-25 |
| 1194266288 | Kaitlin Dingee | Nurse Practitioner | 208 Oak Dr S Ste 502, Lake Jackson, TX 77566 | 2017-03-09 |
| 1366534521 | Theresa Renee Arriaga | Nurse Practitioner | 207a That Way St, Lake Jackson, TX 77566-5211 | 2006-09-28 |
| 1679681696 | Blinn Stewart Bolcar-lunsford | Nurse Practitioner | 135 Oyster Creek Dr Ste B, Lake Jackson, TX 77566-4119 | 2006-08-29 |
| 1336746981 | Brandy Vandergrifft | Nurse Practitioner | 201 Oak Dr S Ste 203, Lake Jackson, TX 77566-5627 | 2020-10-07 |
| 1871121426 | Jessica Evans | Nurse Practitioner | 201 That Way St, Lake Jackson, TX 77566-5211 | 2020-03-30 |
| 1124678511 | Carolyn Celestine Charles | Nurse Practitioner | 106 Circle Way St, Lake Jackson, TX 77566-5266 | 2019-09-17 |
| 1700434859 | J&s Medical Services, LLC | Nurse Practitioner | 135 Oyster Creek Dr Ste E, Lake Jackson, TX 77566-4119 | 2019-09-02 |
| 1366007551 | Krysta Danae Thompson | Nurse Practitioner | 115 Abner Jackson Pkwy Ste C, Lake Jackson, TX 77566-5157 | 2019-05-03 |
| Find all providers in LAKE JACKSON | ||||
| City | LAKE JACKSON |
| Zip Code | 77566 |
Please comment or provide details below to improve the information on MS. VICTORIA LYNN TYRA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.