MEDICARE: KENTON READING ASSOCIATES

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1528485810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENTON READING ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 1288
Second Line	:
City	:	CROSBY
State	:	TX
Zip	:	77532-1288
Country	:	US
Telephone Number	:	281-324-5660
Fax Number	:	281-324-5679

Provider Business Practice Location Address
First Line	:	4131 ZENOBIA ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-2235
Country	:	US
Telephone Number	:	281-324-5660
Fax Number	:	281-324-5679

Authorized Official
Title or Position	:	OWNER
Name	:	TYLER ROOT
Credential	:
Telephone Number	:	281-324-5660

Provider Enumeration Date	:	03/25/2014
Last Update Date	:	03/25/2014

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