Provider Demographics
NPI:1659642403
Name:YAMAUCHI, KYLE HIROMI (PT)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:HIROMI
Last Name:YAMAUCHI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 PIPERS WALK
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 N POST OAK RD
Practice Address - Street 2:SUIT 145
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3839
Practice Address - Country:US
Practice Address - Phone:832-661-9767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11783972251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports