Provider Demographics
NPI:1891920583
Name:KINDLE, MATTHEW OWEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:OWEN
Last Name:KINDLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5826 NEW COPELAND RD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-6217
Mailing Address - Country:US
Mailing Address - Phone:903-592-7200
Mailing Address - Fax:903-592-7211
Practice Address - Street 1:5826 NEW COPELAND RD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-6217
Practice Address - Country:US
Practice Address - Phone:903-592-7200
Practice Address - Fax:903-592-7211
Is Sole Proprietor?:No
Enumeration Date:2009-05-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2004213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery