Organization
LAKEVIEW ENT, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE KENNEDY M.D. (PRESIDENT)
(806) 674-8261
Entity
Organization
Contact information
Practice address
6301 GASTON AVE, DALLAS, TX 75214-3922
(806) 674-8261
(214) 691-8292
Mailing address
PO BOX 181022, DALLAS, TX 75218-8022
(806) 674-8261
(214) 691-8292
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
K0325
TX
Other
Enumeration date
01/09/2014
Last updated
01/09/2014
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