Individual
KYLE EDWARD DOUGHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 GASTON AVE, SUITE 1158, DALLAS, TX 75246-1800
(214) 820-8585
(214) 820-8590
Mailing address
3600 GASTON AVE, SUITE 1158, DALLAS, TX 75246-1800
(214) 820-8585
(214) 820-8590
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M1077
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147501001
—
TX
05
—
174501002
—
TX
05
—
174501004
—
TX
01
—
8BR085
BCBS
TX
01
—
8P8217
BCBS
TX
Enumeration date
06/11/2006
Last updated
08/19/2009
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