Provider Demographics
NPI:1174658660
Name:KYPUROS, HECTOR (MS,CCC-A)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:KYPUROS
Suffix:
Gender:M
Credentials:MS,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 FOREST LN STE 42
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-4160
Mailing Address - Country:US
Mailing Address - Phone:214-357-1144
Mailing Address - Fax:214-250-8086
Practice Address - Street 1:3530 FOREST LN STE 42
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-4160
Practice Address - Country:US
Practice Address - Phone:214-357-1144
Practice Address - Fax:214-250-8086
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51400237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176883001Medicaid