Tyra Michelle Wilson, PA
Physician Assistant in Shenandoah, TX. Individual provider (NPI-1).
NPI number1194453597
StatusActive
Last updated in NPPESOct 7, 2026
Details
- NPI
- 1194453597
- Entity type
- Individual (NPI-1)
- Name
- Tyra Michelle Wilson
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 12, 2022
- Certification date
- Oct 7, 2026
- Last updated
- Oct 7, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA18907 | TX | Yes |
Practice location
134 Vision Park Blvd Ste 310Shenandoah, TX 77384-3032
Phone 936-447-9452
Mailing address
1201 W University DrEdinburg, TX 78539-2909
Phone 956-665-7049
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All 48 Physician Assistant providers in Shenandoah · All 1,294 providers in Shenandoah
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