Provider Demographics
NPI:1528467974
Name:BURROWS, KYLE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:BURROWS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-3059
Mailing Address - Country:US
Mailing Address - Phone:830-331-8420
Mailing Address - Fax:830-331-1255
Practice Address - Street 1:1100 N MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3059
Practice Address - Country:US
Practice Address - Phone:830-331-8420
Practice Address - Fax:830-331-1255
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1245867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist