Tyler Ann Gipson, PHARMD
Individual provider Active NPI Pharmacist · Athens, TX
NPI 1831888098 · NPPES record last updated May 3, 2023
Key facts
- NPI
- 1831888098
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 64906 (TX)
- Practice address
- 115 Medical Cir Ste 106B
Athens, TX 75751-9004 - Phone
- (903) 877-5067
- NPI assigned
- May 3, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64906 | TX | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oncology Pharmacist | 1835X0200X | 64906 | TX | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 64906 | TX | |
| Pharmacist | 183500000X | 64906 | TX | Yes |
| Compounded Sterile Preparations Pharmacist | 1835C0207X | 64906 | TX |
Addresses
Primary practice location
115 Medical Cir Ste 106B
Athens, TX 75751-9004
Mailing address
1110 Mill Run Rd
Athens, TX 75751-3521
Other names
- Tyler Gipson Fowler
Other providers in Athens, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.