Deaver, Tara Yvette

Deaver, Tara Yvette is an sole proprietor health care provider with primary practice located at 701 W 5Th St Ttuhsc Department Of Family Medicine, Odessa TX 79763-4206. She recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is her primary health care specialty. Deaver, Tara Yvette can be contacted via phone (432) 703-5200.

Contact Information

Primary practice address
701 W 5Th St Ttuhsc Department Of Family Medicine Odessa TX 79763-4206
Phone: (432) 703-5200
Fax: (432) 335-5316
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 1425 Texas
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 1425 Texas

Profile Details

NPI number 1548207731
LBN Legal business name Deaver, Tara Yvette
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 31st, 2006
Last updated May 19th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548207731 NPPES
Texas MEDICAID 041798202

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