Provider Demographics
NPI:1497939516
Name:JENSEN, KYLE WESLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:WESLEY
Last Name:JENSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7713 SAN JACINTO PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3215
Mailing Address - Country:US
Mailing Address - Phone:913-439-9645
Mailing Address - Fax:
Practice Address - Street 1:7713 SAN JACINTO PL
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3215
Practice Address - Country:US
Practice Address - Phone:913-439-9645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor