Healthcare Provider Details

I. General information

NPI: 1114843356
Provider Name (Legal Business Name): TYLER W PHARIS OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7005 N MAPLE AVE STE 104
FRESNO CA
93720-8009
US

IV. Provider business mailing address

3700 LOMA VISTA PKWY APT 2608
CLOVIS CA
93619-9841
US

V. Phone/Fax

Practice location:
  • Phone: 559-325-3503
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT28858
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: