Provider Demographics
NPI:1528463379
Name:BARNES, BRIAN KYLE (PA-C)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:KYLE
Last Name:BARNES
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:3503 PAESANOS PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1225
Mailing Address - Country:US
Mailing Address - Phone:210-504-3650
Mailing Address - Fax:210-519-3045
Practice Address - Street 1:1330 BOILING SPRINGS RD STE 1600
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-4219
Practice Address - Country:US
Practice Address - Phone:864-582-6396
Practice Address - Fax:864-582-1608
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2025-07-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ5904363A00000X
TXPA13355363A00000X
SC5814363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5814OtherSCLLR
TXPA13355OtherTEXAS MEDICAL BOARD