Kyle Lake

NPI 1548860737 · on the registry since 2020 · sole proprietor

Practice

Address: 401 N Us Highway 75
Denison, TX 75020
Phone: (903) 465-8035
Fax: (903) 465-0590
Organisation at this address: Wal-Mart Stores Texas, Lp
Wal-Mart Stores Texas Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 4

Registry record

Primary taxonomy: Pharmacist
183500000X
Licence states on file: TX
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2020-10-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas