Kyndal Rae Bullock
Individual provider Active NPI Behavior Technician · Kaufman, TX
NPI 1629933296 · NPPES record last updated Dec 17, 2025
Key facts
- NPI
- 1629933296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-24-358040 (TX)
- Practice address
- 2700 Commerce Way Ste 400
Kaufman, TX 75142-7362 - Phone
- (469) 804-6153
- Fax
- (317) 334-7336
- NPI assigned
- Dec 17, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-358040 | TX | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-358040 | TX | Yes |
Addresses
Primary practice location
2700 Commerce Way Ste 400
Kaufman, TX 75142-7362
Mailing address
2220 H G Mosley Pkwy
Longview, TX 75604-3663
Phone (903) 353-9247
Other providers in Kaufman, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.