Individual
COURTNEY S KYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6000 S. MOPAC EXPRESSWAY, SUITE 200, AUSTIN, TX 78749-7874
(512) 244-4272
Mailing address
2000 S MAYS ST STE 201, ROUND ROCK, TX 78664-7580
(512) 244-4272
(512) 275-2833
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00470
TX
363AM0700X
Medical Physician Assistant
PA00470
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202347502
—
TX
05
—
202347505
—
TX
Enumeration date
05/27/2005
Last updated
04/13/2021
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