Provider Demographics
NPI:1083090161
Name:OYLER, KRISTIE (PT)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:OYLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:BENJAMIN
Mailing Address - State:TX
Mailing Address - Zip Code:79505-0251
Mailing Address - Country:US
Mailing Address - Phone:806-773-5561
Mailing Address - Fax:
Practice Address - Street 1:300 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:TX
Practice Address - Zip Code:76424-4804
Practice Address - Country:US
Practice Address - Phone:254-559-2099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1026482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist