Healthcare Provider Details

I. General information

NPI: 1447373741
Provider Name (Legal Business Name): KYLE BABICK PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 05/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8340 MEADOW RD SUITE 134
DALLAS TX
75231-3769
US

IV. Provider business mailing address

8340 MEADOW RD SUITE 134
DALLAS TX
75231-3769
US

V. Phone/Fax

Practice location:
  • Phone: 214-559-5757
  • Fax: 214-378-7009
Mailing address:
  • Phone: 214-559-5757
  • Fax: 214-378-7009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number23421
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: