Provider Demographics
NPI:1437510716
Name:SALLEE, KYNDRA (DO)
Entity Type:Individual
Prefix:MRS
First Name:KYNDRA
Middle Name:
Last Name:SALLEE
Suffix:
Gender:F
Credentials:DO
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 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HORSESHOE BAY CLINIC (RHC)
Practice Address - Street 2:100 PECAN CROSSING DRIVE
Practice Address - City:HORSESHOE BAY
Practice Address - State:TX
Practice Address - Zip Code:78657-6097
Practice Address - Country:US
Practice Address - Phone:830-596-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS3293207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program