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General NPI Number Information
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NPI Number | 1760021018
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Entity Type | Individual
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Provider Name | KYLER LUKE TEMPLETON LAT
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Gender | Male
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Dates
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Enumeration Date | 01/04/2020
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Last Update Date | 01/04/2020
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Provider Practice Location Address
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Address Line | 3211 47TH ST
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City | LUBBOCK
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State | TX
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Zip | 79413-4112
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Country | US
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Telephone | 806-219-1954
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Fax |
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Provider Business Mailing Address
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Address Line | 7711 AVENUE J
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City | LUBBOCK
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State | TX
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Zip | 79423-4527
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Country | US
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Telephone | 325-370-8212
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | AT5910
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License Number State | TX
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