DR. KYLE PRESTON ANDERSON (NPI# 1508072695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508072695 |
| Entity Type | Individual |
| Full Name | DR. KYLE PRESTON ANDERSON |
| Credential | M.D. |
| Practice Address |
3615 19th St Lubbock TX 79410-1203 |
| Mailing Address |
3420 22nd Pl Lubbock TX 79410-1314 |
| Practice Telephone | 8067252233 |
| Practice Fax Number | 8067250053 |
| Mailing Telephone | 8067255844 |
| Mailing Fax Number | 8067236532 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2013-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 204058 | LA | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | N3449 | TX | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 204058 | LA | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | FIRSTCARE | 920057100 | 01 |
| NM | 985396566 | 05 | |
| TX | BCBS | 8DV404 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932523792 | Kyle Charles Anderson | Physical Therapist | 15 S 1000 E Ste 25, Payson, UT 84651-5595 | 2014-02-13 |
| 1326383100 | Kyle C Anderson | Nurse Anesthetist, Certified Registered | 22 Bridge St Ste 9, Concord, NH 03301-4987 | 2012-12-04 |
| 1720221617 | Kyle Anderson | Dermatology | 11301 Nall Ave Fl 2, Bmo Harris Bank Bldg., Leawood, KS 66211-1672 | 2009-04-08 |
| 1952383176 | Kyle Anderson | Orthopaedic Surgery | 32270 Telegraph Rd Ste 220b, Bingham Farms, MI 48025-2456 | 2005-11-15 |
| 1770576332 | Kyle R. Anderson | Internal Medicine | 730 Malabar Rd, Malabar, FL 32950-3140 | 2005-08-29 |
| 1447870571 | Kyle Anderson | Counselor | 3430 Sw 320th St, Federal Way, WA 98023-2292 | 2020-04-18 |
| 1992333215 | Kyle John Anderson | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2020-03-31 |
| 1417580945 | Kyle Anderson | Pharmacist | 812 S 1st Ave, Iowa City, IA 52245-5208 | 2020-02-12 |
| 1912540980 | Kyle Edward Anderson | Nurse Practitioner | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2019-10-23 |
| 1982170676 | Kyle Christian Anderson | Nurse Practitioner | 1205 S Grange Ave Ste 407, Sioux Falls, SD 57105-0410 | 2018-10-19 |
| Street Address |
3615 19TH ST |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79410-1203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144217100 | Thelma Wong Sutter | Specialist | 3615 19th St, Lubbock, TX 79410-1203 | 2005-10-04 |
| 1831798685 | Jacob Don Paul | Nurse Practitioner | 3615 19th St, Lubbock, TX 79410-1203 | 2020-10-22 |
| 1336778711 | Ephraim Joseph Anderson | Religious Nonmedical Practitioner | 3615 19th St, Lubbock, TX 79410-1203 | 2020-04-07 |
| 1275188229 | Emily White | Registered Nurse | 3615 19th St, Lubbock, TX 79410-1203 | 2019-08-06 |
| 1811456569 | Melinda Dixon | Nurse Practitioner | 3615 19th St, Lubbock, TX 79410-1209 | 2019-03-12 |
| 1134693880 | Alexandra D Bates | Nurse Practitioner | 3615 19th St, Lubbock, TX 79410-1203 | 2019-01-16 |
| 1790256915 | Alyssa Taylor | Pharmacist | 3615 19th St, Lubbock, TX 79410-1209 | 2018-12-16 |
| 1346723517 | Matthew E Heers | Physical Therapy Assistant | 3615 19th St, Lubbock, TX 79410-1203 | 2018-09-12 |
| 1417468992 | Tyler Little | Physician Assistant | 3615 19th St, Lubbock, TX 79410-1203 | 2017-10-23 |
| 1598294712 | David Marsh | Emergency Medicine | 3615 19th St, Lubbock, TX 79410-1203 | 2017-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878267 | Covenant Medical Center | Clinic/Center | 3615 19th, Lifestyle Centre-east Parking Garage, Lubbock, TX 79410 | 2020-07-20 |
| 1669038626 | Hub City Anesthesia | Nurse Anesthetist, Certified Registered | 3416 22nd Street, Lubbock, TX 79410 | 2019-05-15 |
| 1912447418 | Lubbock Surgery Center, LLC | Clinic/Center | 3416 22nd St, Lubbock, TX 79410 | 2017-03-02 |
| 1871032698 | Lezlee Berry | Pharmacist | 3615 19th Street, Lubbock, TX 79410 | 2017-02-13 |
| 1376914101 | Matthew Cotton | Nurse Practitioner | 2424 Quaker Ave, Lubbock, TX 79410 | 2015-10-20 |
| 1841534864 | Frank Nwabugwu | Pharmacist | 4120 34th Street, Lubbock, TX 79410 | 2012-11-15 |
| 1689954794 | Dharmendra Kumar | Pediatrics | Covenant Children's Hospital, 4000 24th Street, Lubbock, TX 79410 | 2011-08-19 |
| 1518277177 | T.r.m. Rao, M.d., P.a. | Colon & Rectal Surgery | 3809 22nd Street, Suite C, Lubbock, TX 79410 | 2010-10-18 |
| 1700196672 | Hanford Consultations P.a. | Family Medicine | 4000 22nd Place Suite 100, Lubbock, TX 79410 | 2010-10-13 |
| 1336452598 | Amanda Collins | Specialist | 4801 34th Street, Lubbock, TX 79410 | 2010-07-16 |
| Find all providers in zip 79410 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144648700 | Jared Walker | Emergency Medicine | 4110 17th St, Apt. 311, Lubbock, TX 79416-6042 | 2014-04-01 |
| 1629159603 | Tom R Basye | Emergency Medicine | 7905 Milwaukee Ave, Lubbock, TX 79424-0616 | 2006-10-18 |
| 1679669089 | Leslie Ralph Shauf | Emergency Medicine | 6505 2nd Street, Lubbock, TX 79416-3709 | 2006-10-04 |
| 1245252428 | Eldon Stevens Robinson | Emergency Medicine | 2602 50th St, Suite 300, Lubbock, TX 79413-4535 | 2006-07-24 |
| 1639199862 | Justin Tidwell | Emergency Medicine | 604 Indiana, Lubbock, TX 79415 | 2006-07-20 |
| 1083630610 | Concord Medical Group Pllc | Emergency Medicine | 1602 Avenue Q, Lubbock, TX 79401-4732 | 2006-07-15 |
| 1053348631 | Shelton Ray Jackson | Emergency Medicine | 4407 87th St, Lubbock, TX 79424-4229 | 2006-06-27 |
| 1629014782 | Rolando N Torio | Emergency Medicine | 5811 - 11 Place, Suite 8, Lubbock, TX 79416 | 2006-06-20 |
| 1902855653 | Lhh Emergency Physicians Pllc | Emergency Medicine | 4810 N Loop 289, Lubbock, TX 79416-3025 | 2006-05-09 |
| 1962467761 | Linda Aryain Robins | Emergency Medicine | 4015 22nd Place, Lubbock, TX 79410-1121 | 2006-04-18 |
| Find all providers in LUBBOCK | ||||
Please comment or provide details below to improve the information on DR. KYLE PRESTON ANDERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.