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General NPI Number Information
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NPI Number | 1700231248
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Entity Type | Individual
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Provider Name | KYLE MILLS D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2016
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 3501 KNICKERBOCKER RD
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City | SAN ANGELO
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State | TX
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Zip | 76904-7610
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Country | US
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Telephone | 325-947-6960
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Fax |
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Provider Business Mailing Address
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Address Line | 3501 KNICKERBOCKER RD
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City | SAN ANGELO
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State | TX
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Zip | 76904-7610
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Country | US
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Telephone | 325-947-6960
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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 | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | R7276
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License Number State | TX
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