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General NPI Number Information
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NPI Number | 1033932595
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Entity Type | Individual
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Provider Name | KYLE BRANDON BUNDAS MSN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 604 S 3RD ST STE A
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City | MABANK
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State | TX
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Zip | 75147-2727
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Country | US
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Telephone | 903-887-1073
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Fax |
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Provider Business Mailing Address
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Address Line | 836 HEBERLE DR
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City | BURLESON
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State | TX
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Zip | 76028-7474
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Country | US
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Telephone | 817-988-3036
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 851751
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1186921
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License Number State | TX
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