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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TYRA MICHELLE WILSON PA
NPI 1194453597
Physician Assistant in Shenandoah, TX

Active since August 12, 2022PECOS Enrolled
134 VISION PARK BLVD STE 310, SHENANDOAH, TX 77384(936) 447-9452 Get Directions Write a Review

NPPES record last updated: October 7, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 7, 2026, Apr 9, 2025, Aug 12, 2022 (3 updates tracked since 2022).

About Tyra Michelle Wilson Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYRA MICHELLE WILSON PA (NPI 1194453597) is an individual physician assistant in Shenandoah, Texas, licensed in Texas (PA18907) and active in the NPI registry since August 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194453597
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameTYRA MICHELLE WILSONCredential: PA
Location Address134 VISION PARK BLVD STE 310Shenandoah, TX 77384-3032
Mailing Address1201 W University DrEdinburg, TX 78539-2909 · (956) 665-7049
Phone(936) 447-9452
Sole ProprietorNo
Enumeration DateAugust 12, 2022
Last NPPES UpdateOctober 7, 20263 updates tracked since enumeration
NPPES CertifiedOctober 7, 2026
✔ NPI 1194453597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA18907
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
134 VISION PARK BLVD STE 310, Shenandoah, TX 77384
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tyra Michelle Wilson Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77384 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANGELA DENISE LINCOLN CNP
Nurse Practitioner (Family)
134 VISION PARK BLVD STE 310
SHENANDOAH, TX 77384
Montgomery County (936) 447-9452
PAUL WAYNE DECKER MD
Family Medicine
134 VISION PARK BLVD STE 310
SHENANDOAH, TX 77384
Montgomery County (936) 447-9452
JUDITH ELIZABETH STRAPP PA-C
Physician Assistant (Medical)
134 VISION PARK BLVD STE 310
SHENANDOAH, TX 77384
Montgomery County (936) 447-9452

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyra Wilson's NPI number?

The NPI number for Tyra Wilson is 1194453597. It was assigned to this individual provider in the NPPES registry on August 12, 2022.

Where is Tyra Wilson located?

Tyra Wilson practices at 134 Vision Park Blvd Ste 310, Shenandoah, TX 77384. The listed phone number is (936) 447-9452.

What is Tyra Wilson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Tyra Wilson enrolled in Medicare?

Yes. Tyra Wilson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tyra Wilson was last updated on October 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.