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General NPI Number Information
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NPI Number | 1922755958
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Entity Type | Organization
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Legal Business Name | KINEMATICS AND PROSTHETICS REHABILITATION INSTITUTE LLC
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 8035 E RL THRTN FWY STE 324
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City | DALLAS
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State | TX
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Zip | 75228-7072
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Country | US
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Telephone | 321-217-9297
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Fax |
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Provider Business Mailing Address
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Address Line | 4714 COYOTE TRL
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City | DALLAS
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State | TX
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Zip | 75227-2821
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Country | US
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Telephone | 321-217-9297
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Fax |
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Authorized Official
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Title or Position | PROSTHETIST
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Name | MR. BILLY GORDON
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Credential | LP, CP
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Telephone | 321-217-9297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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