Individual
KYLE MCGANNON-BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
3100 PREMIER DR STE 234, IRVING, TX 75063-2693
(972) 756-1222
Mailing address
16800 DALLAS PKWY STE 234, DALLAS, TX 75248-1907
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
RBT-18-69208
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-18-69208
BACB
—
Enumeration date
02/20/2019
Last updated
02/20/2019
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