Individual provider Active NPI

Latonia Evette Tyler, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • San Antonio, TX
National Provider Identifier
1225003577
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01057585A Issued in IN
Practice address
6603 First Park Ten Blvd
San Antonio, TX 78213-4303
Phone
(210) 735-9461
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X N8357 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01057585A IN Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X TELEMEDICINE 1616 MN
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 46379 TN

Addresses

Primary practice location

6603 First Park Ten Blvd
San Antonio, TX 78213-4303

Mailing address

11603 Crosswinds Way Ste 115
San Antonio, TX 78233-6005
Phone (210) 585-5093

Other names 1

  • Latonia Evette Roach Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01057585AINMDAnatomic Pathology & Clinical Pathology Physician
TELEMEDICINE 1616MNMDAnatomic Pathology & Clinical Pathology Physician
46379TNMDAnatomic Pathology & Clinical Pathology Physician
N8357TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laboratory Corporation of America Past Accepting new patients
Laboratory Corporation of America PastSince Apr 25, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1225003577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11603 CROSSWINDS WAY STE 115",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782336005",
            "telephone_number": "210-585-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6603 FIRST PARK TEN BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134303",
            "telephone_number": "210-735-9461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "LATONIA",
        "middle_name": "EVETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "N8357",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01057585A",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "TELEMEDICINE 1616",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "46379",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATONIA",
            "last_name": "ROACH",
            "middle_name": "EVETTE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.