Tyra Mickey, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1123046 Issued in TX

Practice address

3845 Southwest Fwy
Houston, TX 77027-7515

Phone

(832) 219-8302

NPI assigned

Sep 1, 2020

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Southwest Texas Two Medical Group, PLLC

  • Primary Care Clinic/Center
  • Houston, TX
  • NPI 1659950475
  NPD (past)

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1497369052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CENTER BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723147",
            "telephone_number": "504-347-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 SOUTHWEST FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277515",
            "telephone_number": "832-219-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKEY",
        "first_name": "TYRA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "213652",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1123046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynne Fryer Michels, O.D.
• Patricia Mai Michlik, LPC
• Leah Miciotto, MCD, CCC-SLP
• Brittany G Mickey
• Tiffany Mickey
• Kevin Mickle, FNP
• Amy Reyes Miclat, RN, MS, CCRN, APRN-B
• John Ranier De Los Reyes Miclat, PHARMD
• Micro Hospital Ep PLLC
• Microbiology Specialists Inc.

• Family Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.