Active NPI
Tyra Jayde Anderson, OTR
- Occupational Therapist
- Garland, TX
National Provider Identifier
1427392067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 101712
- Practice address
- 705 Walter Reed Blvd
Garland, TX 75042-5726 - Phone
- (972) 487-5098
- Fax
- (972) 487-5098
- NPI assigned
- Nov 20, 2012
- Last updated
- Nov 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 101712 | TX | Primary |
Addresses
Primary practice location
705 Walter Reed Blvd
Garland, TX 75042-5726
Mailing address
705 Walter Reed Blvd
Suite 100
Garland, TX 75042-5726
Phone (972) 487-5570
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101712 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bir JV LLP | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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dba Baylor Institute for Rehabilitation
- Rehabilitation Hospital
- Dallas, TX
- NPI 1538465901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353369600000",
"number": "1427392067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 WALTER REED BLVD",
"address_2": "SUITE 100",
"city": "GARLAND",
"state": "TX",
"postal_code": "750425726",
"telephone_number": "972-487-5570",
"fax_number": "972-487-5098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 WALTER REED BLVD",
"city": "GARLAND",
"state": "TX",
"postal_code": "750425726",
"telephone_number": "972-487-5098",
"fax_number": "972-487-5098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "TYRA",
"middle_name": "JAYDE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-20",
"last_updated": "2012-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "101712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.