Provider Demographics
NPI:1730379934
Name:MATHEWS, J. KYLE (MD)
Entity type:Individual
Prefix:
First Name:J. KYLE
Middle Name:
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 MIDWAY RD
Mailing Address - Street 2:SUITE 210 OR 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6383
Mailing Address - Country:US
Mailing Address - Phone:972-781-1444
Mailing Address - Fax:972-781-1448
Practice Address - Street 1:3108 MIDWAY RD
Practice Address - Street 2:SUITE 210 OR 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6383
Practice Address - Country:US
Practice Address - Phone:972-781-1444
Practice Address - Fax:972-781-1448
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6415207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology