Provider Demographics
NPI:1487416103
Name:NEWBY, KAYLYNN ELAINE
Entity type:Individual
Prefix:DR
First Name:KAYLYNN
Middle Name:ELAINE
Last Name:NEWBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 HOLLY HALL ST APT I
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-4192
Mailing Address - Country:US
Mailing Address - Phone:216-904-0264
Mailing Address - Fax:
Practice Address - Street 1:1120 NASA PKWY STE 320
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3366
Practice Address - Country:US
Practice Address - Phone:346-677-0150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124214225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist