Individual
DR. KYLE BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5201 HARRY HINES BLVD, GRADUATE MEDICAL EDUCATION, DALLAS, TX 75235-7708
(214) 590-8058
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
R6747
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
TX
Other
Enumeration date
04/23/2014
Last updated
05/18/2021
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