Healthcare Provider Details

I. General information

NPI: 1710325188
Provider Name (Legal Business Name): KYLE MARTIN HOWARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 QUAKER AVE FL 2
LUBBOCK TX
79424-3367
US

IV. Provider business mailing address

5219 CITY BANK PKWY STE 35
LUBBOCK TX
79407-3545
US

V. Phone/Fax

Practice location:
  • Phone: 806-793-7257
  • Fax: 806-799-1568
Mailing address:
  • Phone: 806-761-0333
  • Fax: 806-782-0097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ8510
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: