Active NPI
Tyra C Harrell, L.A.T
- Athletic Trainer
- Humble, TX
National Provider Identifier
1477099281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2381
- Practice address
- 19123 Forest Trace Dr
Humble, TX 77346-5045 - Phone
- (832) 419-4035
- NPI assigned
- Jan 18, 2017
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2381 | TX | Primary |
Addresses
Primary practice location
19123 Forest Trace Dr
Humble, TX 77346-5045
Mailing address
19123 Forest Trace Dr
Humble, TX 77346-5045
Phone (832) 419-4035
Other names 1
- Miss Tyra Rochelle Charles
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 |
|---|---|---|---|
| 2381 | TX | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484697600000",
"number": "1477099281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19123 FOREST TRACE DR",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773465045",
"telephone_number": "832-419-4035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19123 FOREST TRACE DR",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773465045",
"telephone_number": "832-419-4035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "TYRA",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "L.A.T",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-18",
"last_updated": "2017-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TX",
"license": "2381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TYRA",
"last_name": "CHARLES",
"middle_name": "ROCHELLE",
"prefix": "MISS",
"credential": "L.A.T",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Humble, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.