Provider Demographics
NPI:1730860347
Name:VARNER, TYLER
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:VARNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 COPPERFIELD DR APT 233
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-5876
Mailing Address - Country:US
Mailing Address - Phone:417-529-7646
Mailing Address - Fax:
Practice Address - Street 1:3780 COPPERFIELD DR APT 233
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-5876
Practice Address - Country:US
Practice Address - Phone:417-529-7646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program