Provider Demographics
NPI:1447312434
Name:BURDITT, KYLE N (PA-C)
Entity type:Individual
Prefix:MR
First Name:KYLE
Middle Name:N
Last Name:BURDITT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7115 BLANCO RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5045
Mailing Address - Country:US
Mailing Address - Phone:210-338-8800
Mailing Address - Fax:210-338-8825
Practice Address - Street 1:7115 BLANCO RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5045
Practice Address - Country:US
Practice Address - Phone:210-338-8800
Practice Address - Fax:210-338-8825
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical