NPI Code Details Logo

NPI 1508770553

NPI 1508770553 : K EXTENSIONS : NEW CANEY, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1508770553
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    K EXTENSIONS 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/29/2026
-----------------------------------------------------
    Last Update Date     |    09/29/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    22695 MALVICINO DR 
-----------------------------------------------------
    City                 |    NEW CANEY
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    77357-2633
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    346-731-3079
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    22695 MALVICINO DR 
-----------------------------------------------------
    City                 |    NEW CANEY
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    77357-2633
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     YORKEYAH  YOUNG 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    346-731-3079
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    335E00000X
-----------------------------------------------------
    Taxonomy Name        |    Prosthetic/Orthotic Supplier
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    NULL
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.