| Kyle Raymond Pa | |
|
5656 Bee Caves Rd Ste B104 Austin TX 78746 | |
| (512) 732-0022 | |
| Not Available |
| Full Name | Kyle Raymond Pa |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5656 Bee Caves Rd Ste B104, Austin, Texas |
| Authorized Official Name and Position | Tammera Torres (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5128094162 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle Raymond Pa 5656 Bee Caves Rd Ste B104 Austin TX 78746 Ph: (512) 732-0022 | Kyle Raymond Pa 5656 Bee Caves Rd Ste B104 Austin TX 78746 Ph: (512) 732-0022 |
| NPI Number | 1902216989 |
|---|---|
| Provider Enumeration Date | 04/30/2014 |
| Last Update Date | 05/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902216989 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 18034 (Texas) | Primary |
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