Healthcare Provider Details

I. General information

NPI: 1891300059
Provider Name (Legal Business Name): KEVIN OYLER HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 MONTGOMERY BLVD NE BLDG E15
ALBUQUERQUE NM
87109-1586
US

IV. Provider business mailing address

7520 MONTGOMERY BLVD NE BLDG E15
ALBUQUERQUE NM
87109-1586
US

V. Phone/Fax

Practice location:
  • Phone: 505-872-4327
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: