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NPI Code Detail

MEDICARE: KAYLA PANOS DPT

MEDICARE: KAYLA PANOS DPT
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
12081S0010XSports Medicine (Physical Medicine & Rehabilitation) Physician1308587TX

General Provider Information

NPI Number : 1396213856
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA PANOS DPT
Provider Business Mailing Address
First Line : 2125 YALE ST APT 327
Second Line :
City : HOUSTON
State : TX
Zip : 77008-2672
Country : US
Telephone Number : 512-912-6800
Fax Number :
Provider Business Practice Location Address
First Line : 17600 INTERSTATE 45 S
Second Line :
City : CONROE
State : TX
Zip : 77384-5148
Country : US
Telephone Number : 936-267-7391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2018
Last Update Date : 11/02/2018

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Directions to “ KAYLA PANOS DPT” Practice Location

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