Tyler Wiatrek, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT5027 Issued in TX

Practice address

3251 Austins Colony Pkwy
Bryan, TX 77808-2276

Phone

(979) 209-7929

NPI assigned

Dec 11, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1699542571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 BRAZOS BND",
            "city": "SOMERVILLE",
            "state": "TX",
            "postal_code": "778791160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 AUSTINS COLONY PKWY",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778082276",
            "telephone_number": "979-209-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIATREK",
        "first_name": "TYLER",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT5027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Whiting
• Jill Michelle Whitley, PA-C
• Wade W Whitmer, M.D.
• Andrew G Whitmire, MD
• Whole Vision PA
• Kelley Wiederhold, LPC-ASSOCIATE
• Wifi Medical LLC
• Grace Marie Wightman, MED
• Kennon D Wigley, MD
• Wilbea Medical Equipment LLC

• Athletic Trainer in Bryan, TX
• Providers in Bryan, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.