KYRA NICOLE LOGAN (NPI# 1558863555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558863555 |
| Entity Type | Individual |
| Full Name | KYRA NICOLE LOGAN |
| Credential | PA-C |
| Practice Address |
221 W Colorado Blvd Pav II Ste. 425 Dallas TX 75208-7520 |
| Mailing Address |
221 W. Colorado Blvd. Pavilion II Suite 425 Dallas TX 75208 |
| Practice Telephone | 2149473231 |
| Practice Fax Number | 2149473239 |
| Mailing Telephone | 2149473231 |
| Mailing Fax Number | 2149473239 |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2020-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA11881 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
221 W COLORADO BLVD PAV II STE. 425 |
| City | DALLAS |
| State | TX |
| Zip Code | 75208-7520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962048710 | Roshonda Guest | Counselor | 529 W. Commerce, 1414, Dallas, TX 75208 | 2019-11-26 |
| 1316506025 | Molecular Innovations Neo-designs Laboratories, LLC | Clinical Medical Laboratory | 839 W. Commerce, Dallas, TX 75208 | 2019-06-07 |
| 1477023430 | Amber M James Dmd, Pllc | Dentist | 650 Fort Worth Ave, Ste 130, Dallas, TX 75208 | 2018-12-03 |
| 1659841237 | Andrea Pavia-jimenez | Physician Assistant | 817 Jefferson Blvd, Dallas, TX 75208 | 2018-11-27 |
| 1841716859 | Jennifer Atherton | Midwife | 618 S Rosemont Ave, Dallas, TX 75208 | 2017-08-22 |
| 1659815892 | Texas Traumatic Brain Injury Rehab | Counselor | 214 W. Colorado Blvd., Dallas, TX 75208 | 2016-12-07 |
| 1295120111 | Silva Pharmacy, Inc | Pharmacy | 939 W Jefferson Blvd Ste 101, Dallas, TX 75208 | 2015-03-30 |
| 1487052478 | Kassandra Sanchez | Counselor | 210 West 10th Street, Dallas, TX 75208 | 2014-12-08 |
| 1023458650 | O.c Medical Associates Pa | Internal Medicine | 737 N. Bishop Avenue, Ste B, Dallas, TX 75208 | 2013-06-27 |
| 1306105135 | Sts Dental, Pllc | Dentist | 909 S. Tyler St., Dallas, TX 75208 | 2012-05-14 |
| Find all providers in zip 75208 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641051 | Kelsey Young | Physician Assistant | 12201 Merit Dr Ste 400, Dallas, TX 75251-3117 | 2019-07-17 |
| 1386169175 | Lauren Moore | Physician Assistant | 5201 Harry Hines Blvd Fl Htower1, Dallas, TX 75235-7708 | 2017-08-14 |
| 1811427594 | Jena Benik | Physician Assistant | 7777 Forest Ln Ste B122, Dallas, TX 75230-6806 | 2017-06-15 |
| 1881123909 | One Healthcare LLC | Physician Assistant | 1722 Routh St Ste 900, Dallas, TX 75201-2588 | 2017-06-12 |
| 1972037307 | Morrison Medical | Physician Assistant | 17746 Preston Rd Ste 100, Dallas, TX 75252-5736 | 2017-04-12 |
| 1205297652 | Keri Miller | Physician Assistant | 9780 Lbj Fwy Ste 124, Dallas, TX 75243-6847 | 2016-03-14 |
| 1275907776 | Aleshia Mutai | Physician Assistant | 5800 E Lovers Ln, Dallas, TX 75206-2901 | 2015-11-20 |
| 1588049613 | Yvonne Conard | Physician Assistant | 2650 Cedar Springs Rd, #5535, Dallas, TX 75201-1495 | 2015-07-30 |
| 1699174599 | John Michael Cline | Physician Assistant | 5201 Harry Hines Boulevard, Psychiatric Emergency Room, Dallas, TX 75235 | 2014-08-15 |
| 1821439001 | Divya Thomas | Physician Assistant | 610 E Jefferson Blvd Suite 100, Dallas, TX 75094 | 2013-07-16 |
| Find all providers in DALLAS | ||||
Please comment or provide details below to improve the information on KYRA NICOLE LOGAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.