Provider Demographics
NPI:1710785118
Name:BYRD, SKYLAR JALEEN
Entity type:Individual
Prefix:
First Name:SKYLAR
Middle Name:JALEEN
Last Name:BYRD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 E STEWART ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-2150
Mailing Address - Country:US
Mailing Address - Phone:956-237-0988
Mailing Address - Fax:
Practice Address - Street 1:20818 GATHERING OAK STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-3105
Practice Address - Country:US
Practice Address - Phone:210-858-5006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1405928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist