Active NPI
Kylie Barroso, DDS
- Dentist
- Conroe, TX
National Provider Identifier
1508502873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 38830
- Practice address
- 500 Medical Center Blvd Ste 110
Conroe, TX 77304-2800 - Phone
- (936) 760-2200
- NPI assigned
- May 10, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 38830 | TX | Primary |
Addresses
Primary practice location
500 Medical Center Blvd Ste 110
Conroe, TX 77304-2800
Mailing address
7413 Teaswood Dr
Conroe, TX 77304-1402
Phone (936) 520-8340
Other practice location 1
7500 Cambridge St
Houston, TX 77054-2032
Phone (713) 486-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230817000907 | TX | Practitioner - Dentist | 6901268317 | Practice locations: Conroe, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38830 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684108800000",
"number": "1508502873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7413 TEASWOOD DR",
"city": "CONROE",
"state": "TX",
"postal_code": "773041402",
"telephone_number": "936-520-8340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 MEDICAL CENTER BLVD STE 110",
"city": "CONROE",
"state": "TX",
"postal_code": "773042800",
"telephone_number": "936-760-2200"
}
],
"practiceLocations": [
{
"address_1": "7500 Cambridge St",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770542032",
"country_code": "US",
"telephone_number": "713-486-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BARROSO",
"first_name": "KYLIE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-10",
"last_updated": "2023-05-15",
"certification_date": "2023-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "38830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.