Provider Demographics
NPI:1700387826
Name:BIERLE, KEVIN
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:BIERLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 MCKINNEY ST
Mailing Address - Street 2:
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454-9762
Mailing Address - Country:US
Mailing Address - Phone:972-837-4450
Mailing Address - Fax:972-837-4451
Practice Address - Street 1:3201 MCKINNEY ST
Practice Address - Street 2:
Practice Address - City:MELISSA
Practice Address - State:TX
Practice Address - Zip Code:75454-9762
Practice Address - Country:US
Practice Address - Phone:972-837-4450
Practice Address - Fax:972-837-4451
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist