MEDICARE: KAYLA VANDERKAR

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	225100000X	Physical Therapist		TX

General Provider Information

NPI Number	:	1447119128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA VANDERKAR

Provider Business Mailing Address
First Line	:	107 HANCOCK ST
Second Line	:
City	:	VENUS
State	:	TX
Zip	:	76084-3726
Country	:	US
Telephone Number	:	214-725-9609
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 S MIDLOTHIAN PKWY STE 170
Second Line	:
City	:	MIDLOTHIAN
State	:	TX
Zip	:	76065-5597
Country	:	US
Telephone Number	:	972-723-0380
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ KAYLA VANDERKAR ” Practice Location

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