Provider Demographics
NPI:1144260845
Name:FYKE, DENNIS CARL (ATC)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:CARL
Last Name:FYKE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22335 FIELDCREST LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5645
Mailing Address - Country:US
Mailing Address - Phone:281-239-2113
Mailing Address - Fax:
Practice Address - Street 1:4606 MUSTANG AVE
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2121
Practice Address - Country:US
Practice Address - Phone:832-223-3160
Practice Address - Fax:832-223-3001
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT06492255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer