Kyle Groom D.O.

NPI 1063413656 - Family Medicine - 207Q00000X

NPI Details
NPI 1063413656
Gender Male
Enumeration Date 08/03/2005
Last Updated 11/13/2009
Entity Type Individual
Active Over 11 years ago
Practice Location
1250 S RUNNELS ST
DE KALB TX, 75559-2317, US
Phone (903) 667-2273
Fax (903) 667-7597
Business Location
216 N CENTRE ST
DE KALB TX, 75559-1406, US
Phone (903) 667-2273
Fax (903) 667-7597
Toxanomy
Taxonomy Code 207Q00000X
License State Texas
License Number L5749
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According to our database, Dr. Kyle Groom D.O. NPI is 1063413656, taxonomy code is 207Q00000X and license number is L5749, license state is located at Texas. Kyle Groom D.O. physically located at 1250 S Runnels St, De Kalb TX, 75559-2317. NPI Number Kyle Groom D.O. has the Individual type.

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1063413656 NPI number is provided on an as is basis without warranty of any kind. 1063413656 is maintained by the National Plan & Provider Enumeration System. The contents of Kyle Groom D.O. are for informational purposes only.