Healthcare Provider Details

I. General information

NPI: 1730316076
Provider Name (Legal Business Name): KYLE VARVEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2009
Last Update Date: 09/23/2020
Certification Date: 09/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 SAGEBRIAR DR
BRYAN TX
77802-6107
US

IV. Provider business mailing address

3811 SAGEBRIAR DR
BRYAN TX
77802-6107
US

V. Phone/Fax

Practice location:
  • Phone: 979-774-0498
  • Fax: 979-774-7673
Mailing address:
  • Phone: 979-774-0498
  • Fax: 979-774-7673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberP5309
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: