Provider Demographics
NPI:1336413608
Name:BYRNE, KELLY ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ANN
Last Name:BYRNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 S EDMONDS LN STE 102
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3542
Mailing Address - Country:US
Mailing Address - Phone:469-444-3220
Mailing Address - Fax:469-444-3222
Practice Address - Street 1:570 S EDMONDS LN STE 102
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3542
Practice Address - Country:US
Practice Address - Phone:469-444-3220
Practice Address - Fax:469-444-3222
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor