Individual
KAYLA DYNISE EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2201 RICHTER AVE, WACO, TX 76711-1954
(254) 424-6207
Mailing address
2201 RICHTER AVE, WACO, TX 76711-1954
(254) 424-6207
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT8235
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10053642703
SCOTT & WHITE HMO
TX
Enumeration date
03/04/2018
Last updated
06/18/2020
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