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General NPI Number Information
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NPI Number | 1003584608
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Entity Type | Individual
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Provider Name | TRAVIS ANDREW KYLE PA
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Gender | Male
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1001 W EAGLE DR
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City | DECATUR
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State | TX
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Zip | 76234-3745
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Country | US
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Telephone | 940-442-5209
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Fax | 940-222-2720
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Provider Business Mailing Address
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Address Line | 1512 TEASLEY LN
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City | DENTON
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State | TX
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Zip | 76205-7282
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Country | US
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Telephone | 940-442-5209
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Fax | 940-222-2720
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA14482
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License Number State | TX
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