Provider Demographics
NPI:1033975933
Name:CLINICA FAMILIAR KYLE LLC
Entity Type:Organization
Organization Name:CLINICA FAMILIAR KYLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:GREYSI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMAYO GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:512-262-7307
Mailing Address - Street 1:21511 IH 35 STE 105
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6683
Mailing Address - Country:US
Mailing Address - Phone:512-262-7307
Mailing Address - Fax:512-262-0049
Practice Address - Street 1:21511 IH 35 STE 105
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6683
Practice Address - Country:US
Practice Address - Phone:512-262-7307
Practice Address - Fax:512-262-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty