MEDICARE: KNETIC RX LLC

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1639017833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNETIC RX LLC

Provider Business Mailing Address
First Line	:	4621 S COOPER ST STE 131-131
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-5804
Country	:	US
Telephone Number	:	469-702-1996
Fax Number	:

Provider Business Practice Location Address
First Line	:	4621 S COOPER ST STE 131-131
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-5804
Country	:	US
Telephone Number	:	469-702-1996
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BAYLORE WALKER
Credential	:
Telephone Number	:	469-702-1996

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “KNETIC RX LLC ” Practice Location

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