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Individual

KYLE E HOOGENDOORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
6048 LAKE WORTH BLVD, FORT WORTH, TX 76135-3706
(817) 336-1189
(817) 698-8281
Mailing address
6048 LAKE WORTH BLVD, FORT WORTH, TX 76135-3706
(817) 336-1189
(817) 698-8281

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1844
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
198413001
TX
05
198413002
TX
05
198413003
TX
05
198413004
TX
Enumeration date
01/03/2007
Last updated
11/03/2015
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