Healthcare Provider Details

I. General information

NPI: 1518740349
Provider Name (Legal Business Name): KAYLA RUOPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18700 KATY FWY STE 603
HOUSTON TX
77094-0012
US

IV. Provider business mailing address

2770 SUMMER ST APT 253
HOUSTON TX
77007-4368
US

V. Phone/Fax

Practice location:
  • Phone: 832-522-8280
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA19647
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: