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General NPI Number Information
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NPI Number | 1306375100
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Entity Type | Individual
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Provider Name | TYLER BERNARD MS, LAT, ATC, CES
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Gender | Male
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 06/06/2017
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Provider Practice Location Address
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Address Line | 1 UTSA CIR
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City | SAN ANTONIO
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State | TX
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Zip | 78249-1644
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Country | US
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Telephone | 719-641-9788
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Fax |
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Provider Business Mailing Address
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Address Line | 10611 LYNX RANGE
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City | SAN ANTONIO
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State | TX
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Zip | 78251-4021
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Country | US
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Telephone | 719-641-9788
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT7025
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License Number State | TX
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