Provider Demographics
NPI:1609136647
Name:KURT N. DOYLE CST,P.C.
Entity Type:Organization
Organization Name:KURT N. DOYLE CST,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERT. SURGICAL TECH/FIRST ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:N
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:CST
Authorized Official - Phone:817-223-3587
Mailing Address - Street 1:3732 FENTON AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-2916
Mailing Address - Country:US
Mailing Address - Phone:817-223-3587
Mailing Address - Fax:817-370-9020
Practice Address - Street 1:3732 FENTON AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-2916
Practice Address - Country:US
Practice Address - Phone:817-223-3587
Practice Address - Fax:817-370-9020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO127516OtherNATIONAL BOARD OR SURGICAL TECHNOLOGY AND SURGICAL ASSISTING