Provider Demographics
NPI:1487082061
Name:KYLER E ELWELL MD PA
Entity type:Organization
Organization Name:KYLER E ELWELL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:KYLER
Authorized Official - Middle Name:E
Authorized Official - Last Name:ELWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-981-7777
Mailing Address - Street 1:6124 W PARKER RD
Mailing Address - Street 2:STE 134
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8122
Mailing Address - Country:US
Mailing Address - Phone:972-981-7777
Mailing Address - Fax:972-981-7750
Practice Address - Street 1:6124 W PARKER RD
Practice Address - Street 2:STE 134
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8122
Practice Address - Country:US
Practice Address - Phone:972-981-7777
Practice Address - Fax:972-981-7750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5621207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty