Provider Demographics
NPI:1891559837
Name:ERRICSON, KYNDALL BROOKE
Entity Type:Individual
Prefix:
First Name:KYNDALL
Middle Name:BROOKE
Last Name:ERRICSON
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 1:12310 WESTWOLD DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-8045
Mailing Address - Country:US
Mailing Address - Phone:580-585-2800
Mailing Address - Fax:
Practice Address - Street 1:9230 KATY FWY STE 420
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7468
Practice Address - Country:US
Practice Address - Phone:580-585-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty