Individual
MRS. TYARE STANDBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDMS RVT
Contact information
Practice address
15790 PAUL VEGA MD DR, HAMMOND, LA 70403-1436
(985) 345-2700
Mailing address
1049 QUAIL RIDGE DR, MCCOMB, MS 39648-5509
(601) 810-8295
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
164230
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164230
ARDMS
—
Enumeration date
05/10/2020
Last updated
05/10/2020
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