Individual
TANNER VAUGHN BUIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAT, LAT, ATC
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 593-8441
Mailing address
562 CENTENNIAL PKWY APT 701, TYLER, TX 75703-7182
(660) 412-3879
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT9735
TX
Other
Enumeration date
05/20/2022
Last updated
06/27/2024
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