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NPI Code Detail

MEDICARE: DR. ROGER W. KYLBERG MD

MEDICARE: DR. ROGER W. KYLBERG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianH7075TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245226547
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER W. KYLBERG MD
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number : 800-994-0371
Fax Number : 254-215-9722
Provider Business Practice Location Address
First Line : 7556 HONEYSUCKLE
Second Line :
City : TEMPLE
State : TX
Zip : 76502-5631
Country : US
Telephone Number : 254-724-2111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2005
Last Update Date : 01/27/2022

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