Healthcare Provider Details

I. General information

NPI: 1265179865
Provider Name (Legal Business Name): KYLE STEVEN CONLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 4TH ST
LUBBOCK TX
79430-0002
US

IV. Provider business mailing address

716 VENTOSO CIR
WOLFFORTH TX
79382-3401
US

V. Phone/Fax

Practice location:
  • Phone: 806-743-2978
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberU8037
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: