Tyra Fowler

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

68725 Issued in TX

Practice address

2705 Deer Creek CT
Garland, TX 75040-3939

Phone

(972) 898-1630

NPI assigned

Jul 2, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Brave Health Medical Group PA

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1225669161

  Addiction (Substance Use Disorder)

  NPD

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1275916694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 DEER CREEK CT",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750403939",
            "telephone_number": "972-898-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 DEER CREEK CT",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750403939",
            "telephone_number": "972-898-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "TYRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "11623",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "68725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Forsythe, MD
• Farrell David Fort, PHARM. D.
• Fortune Ezeoha and Linda Ezeoha
• Soume Daulat Foshee, MD
• Katherine Foutz, LCSW
• Francis Michael Dba-Francis Michael
• Crissy Franklin
• Mathilda Fredrick, LPC
• Brandi Nicole Freeman, BCBA
• Dawnel Freeman, STA

• Mental Health Counselor in Garland, TX
• Providers in Garland, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.