Provider Demographics
NPI:1649681537
Name:KYLE, YERMESHA (DPM)
Entity type:Individual
Prefix:
First Name:YERMESHA
Middle Name:
Last Name:KYLE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 ST JOSEPH PKWY STE 301
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8229
Mailing Address - Country:US
Mailing Address - Phone:346-204-5528
Mailing Address - Fax:
Practice Address - Street 1:1315 ST JOSEPH PKWY STE 301
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002
Practice Address - Country:US
Practice Address - Phone:346-204-5528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2269213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX374359301Medicaid