Individual
JACK BRITTON KYLE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3713 24TH ST, LUBBOCK, TX 79410-2015
(217) 853-2284
Mailing address
3713 24TH ST, LUBBOCK, TX 79410-2015
(217) 853-2284
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
583215
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP108453
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119911906
—
TX
01
—
84894U
BCBS
TX
Enumeration date
03/21/2007
Last updated
04/24/2023
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