MEDICARE: KYLE DAVID WELCH

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	225X00000X	Occupational Therapist	16020	CA
2	225X00000X	Occupational Therapist	122639	TX

General Provider Information

NPI Number	:	1255790150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE DAVID WELCH

Provider Business Mailing Address
First Line	:	8325 RED ROSE TRL
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76182-8421
Country	:	US
Telephone Number	:	714-403-9382
Fax Number	:

Provider Business Practice Location Address
First Line	:	4524 BOAT CLUB RD STE 180
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76135-7025
Country	:	US
Telephone Number	:	817-764-3825
Fax Number	:

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

Provider Enumeration Date	:	02/19/2016
Last Update Date	:	11/20/2024

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Directions to “ KYLE DAVID WELCH ” Practice Location

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