Provider Demographics
NPI:1225609910
Name:PRINGLE, KAYLEIGH BETH
Entity type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:BETH
Last Name:PRINGLE
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 1:1705 CHAMPIONS DR
Mailing Address - Street 2:
Mailing Address - City:NAVASOTA
Mailing Address - State:TX
Mailing Address - Zip Code:77868-1645
Mailing Address - Country:US
Mailing Address - Phone:903-241-5980
Mailing Address - Fax:
Practice Address - Street 1:400 BIZZELL ST
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77843-0001
Practice Address - Country:US
Practice Address - Phone:979-845-3211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-05
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT94602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer