Provider Demographics
NPI:1083720288
Name:BUCHAN, KYLE WILKEN (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:WILKEN
Last Name:BUCHAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3819 HAVEN PINES DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-1107
Mailing Address - Country:US
Mailing Address - Phone:281-358-7021
Mailing Address - Fax:
Practice Address - Street 1:1110 KINGWOOD DR
Practice Address - Street 2:SUITE 201
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3001
Practice Address - Country:US
Practice Address - Phone:281-359-6932
Practice Address - Fax:281-359-2647
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9058111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8P0500OtherBLUE CROSS BLUE SHIELD
TX666266OtherUNITED HEALTHCARE
TX8P0500OtherBLUE CROSS BLUE SHIELD