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General NPI Number Information
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NPI Number | 1891920583
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Entity Type | Individual
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Provider Name | MATTHEW OWEN KINDLE DPM
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Gender | Male
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Dates
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Enumeration Date | 05/25/2009
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 5826 NEW COPELAND RD
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City | TYLER
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State | TX
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Zip | 75703-6217
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Country | US
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Telephone | 903-592-7200
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Fax | 903-592-7211
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Provider Business Mailing Address
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Address Line | 5826 NEW COPELAND RD
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City | TYLER
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State | TX
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Zip | 75703-6217
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Country | US
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Telephone | 903-592-7200
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Fax | 903-592-7211
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 2004
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License Number State | TX
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