Provider Demographics
NPI:1093472524
Name:GARROW, KYLE REESE (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:REESE
Last Name:GARROW
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6445 FM 1463 RD STE 140
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-4028
Mailing Address - Country:US
Mailing Address - Phone:346-202-6671
Mailing Address - Fax:
Practice Address - Street 1:6445 FM 1463 RD STE 140
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-4028
Practice Address - Country:US
Practice Address - Phone:346-202-6671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059141363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner