Provider Demographics
NPI:1396554473
Name:TREGRE, KYLEIGH BROOKE
Entity type:Individual
Prefix:
First Name:KYLEIGH
Middle Name:BROOKE
Last Name:TREGRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11555 MAGNOLIA PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2151
Mailing Address - Country:US
Mailing Address - Phone:281-724-8241
Mailing Address - Fax:
Practice Address - Street 1:11555 MAGNOLIA PKWY STE 140
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2151
Practice Address - Country:US
Practice Address - Phone:281-724-8241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty