Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1529 | MS |
NPI | 1295822914 |
---|---|
Provider Name | Mr. Robert Kyle Davis |
First Address | Humble, TX 77346-3390 |
Second Address | Houston, TX 77030-4211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |