Provider Demographics
NPI:1669007761
Name:BARNETT, KYLE (PT, DPT, SCS, EMT-B)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:BARNETT
Suffix:
Gender:M
Credentials:PT, DPT, SCS, EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 LOCKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:TAHOKA
Mailing Address - State:TX
Mailing Address - Zip Code:79373-4118
Mailing Address - Country:US
Mailing Address - Phone:806-642-3132
Mailing Address - Fax:
Practice Address - Street 1:2129 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TAHOKA
Practice Address - State:TX
Practice Address - Zip Code:79373-5323
Practice Address - Country:US
Practice Address - Phone:806-642-3132
Practice Address - Fax:806-561-1338
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-09
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13275512251P0200X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports