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NPI Code Detail

MEDICARE: KYLIE FUTRAL

MEDICARE: KYLIE FUTRAL
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1740851369
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLIE FUTRAL
Provider Business Mailing Address
First Line : 5522 LONE STAR PARKWAY
Second Line : BUILDING #3 SUITE 101
City : SAN ANTONIO
State : TX
Zip : 78253
Country : US
Telephone Number : 210-670-8028
Fax Number :
Provider Business Practice Location Address
First Line : 12303 E 104TH PL UNIT 105
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-2098
Country : US
Telephone Number : 720-617-1574
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2021
Last Update Date : 07/06/2021

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Directions to “ KYLIE FUTRAL ” Practice Location

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