MEDICARE: DR. KYLE H FEHLIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	BP10034625	TX
2	207Q00000X	Family Medicine Physician	N7921	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00R38T	OTHER		GROUP MEDICARE
4	1H0127	OTHER	TX	MEDICARE
6	P02569420	OTHER	TX	MEDICARE RAILROAD
7	TXB156234	OTHER		MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	1952326993	OTHER	GROUP NPI
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215167119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYLE H FEHLIS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 311627
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78131-1627
Country	:	US
Telephone Number	:	830-625-0305
Fax Number	:	830-625-2693

Provider Business Practice Location Address
First Line	:	457 LANDA ST STE C
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-5414
Country	:	US
Telephone Number	:	830-627-9088
Fax Number	:	833-973-1245

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2009
Last Update Date	:	08/07/2024

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Directions to “ DR. KYLE H FEHLIS M.D.” Practice Location

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