Healthcare Provider Details

I. General information

NPI: 1932977329
Provider Name (Legal Business Name): TYLER J BROWN PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 W CHARLESTON BLVD STE Y
LAS VEGAS NV
89102-1633
US

IV. Provider business mailing address

3884 RANCHO NIGUEL PKWY
LAS VEGAS NV
89147-8015
US

V. Phone/Fax

Practice location:
  • Phone: 818-894-2273
  • Fax: 818-357-2505
Mailing address:
  • Phone: 702-715-8537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number6321
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6321
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: