Healthcare Provider Details

I. General information

NPI: 1033475330
Provider Name (Legal Business Name): TYLER NEWELL COOPER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 QUAIL CREEK DR
AMARILLO TX
79124
US

IV. Provider business mailing address

501 QUAIL CREEK DR
AMARILLO TX
79124-1621
US

V. Phone/Fax

Practice location:
  • Phone: 806-418-2548
  • Fax: 806-367-6307
Mailing address:
  • Phone: 806-418-2548
  • Fax: 806-367-6307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberR4531
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: