Healthcare Provider Details

I. General information

NPI: 1417545567
Provider Name (Legal Business Name): TYLER N. COOPER, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2021
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
79124-1621
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 Number
License Number State

VIII. Authorized Official

Name: SAMANTHA ADAMS
Title or Position: OFFICE MANAGER
Credential:
Phone: 806-418-2548