Provider Demographics
NPI:1437272747
Name:KYLE BABICK PH.D. AND ASSOCIATES, PC
Entity Type:Organization
Organization Name:KYLE BABICK PH.D. AND ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BABICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-559-5757
Mailing Address - Street 1:8340 MEADOW RD
Mailing Address - Street 2:SUITE 134
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3769
Mailing Address - Country:US
Mailing Address - Phone:214-559-5757
Mailing Address - Fax:214-378-7009
Practice Address - Street 1:8340 MEADOW RD
Practice Address - Street 2:SUITE 134
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3769
Practice Address - Country:US
Practice Address - Phone:214-559-5757
Practice Address - Fax:214-378-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23421103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCPS23421TXOtherTEXAS WORKERS COMP PROVID
0A3419OtherMEDICARE GROUP PTAN