Provider Demographics
NPI:1467774943
Name:BYBEE, KRISTY RUTHANN (DO)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:RUTHANN
Last Name:BYBEE
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6483
Mailing Address - Fax:682-885-3113
Practice Address - Street 1:4100 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-3123
Practice Address - Country:US
Practice Address - Phone:945-204-4100
Practice Address - Fax:682-885-1903
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8492208000000X, 2080P0204X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00682721Medicaid
TX8GV956OtherBCBS
TX282023504Medicaid
1467774943OtherFIRSTCARE