Provider Demographics
NPI:1598521858
Name:FELIX, KRISTIN TAYLOR
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:TAYLOR
Last Name:FELIX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7517 FOXGRASS PL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-2447
Mailing Address - Country:US
Mailing Address - Phone:469-688-7128
Mailing Address - Fax:
Practice Address - Street 1:7517 FOXGRASS PL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-2447
Practice Address - Country:US
Practice Address - Phone:469-688-7128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant