Provider Demographics
NPI:1861534182
Name:DEMLER, KYLE T (DO)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:T
Last Name:DEMLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:364 CANYON CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76087-4041
Mailing Address - Country:US
Mailing Address - Phone:817-599-8057
Mailing Address - Fax:817-599-8067
Practice Address - Street 1:364 CANYON CREEK CIR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76087-4041
Practice Address - Country:US
Practice Address - Phone:817-599-8057
Practice Address - Fax:817-599-8067
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF-3097207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139063536Medicaid
TX328254YKN5Medicare PIN
TXD75127Medicare UPIN