Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | H6415 | TX |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | H6415 | TX |
NPI | 1730379934 |
---|---|
Provider Name | J. Kyle Mathews |
First Address | Plano, TX 75093-6383 |
Second Address | Plano, TX 75093-6383 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 20/10/2015 |