Individual ProviderKevin Dale LangePhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4208 Retama Cir, Victoria, TX 77901-2765(361) 582-0611PECOS EnrollmentBased on the most recent information from CMS, provider Kevin Dale Lange does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1689096539Provider TypeIndividualFull NameLange, Kevin DaleCredentialPTGenderMaleSole ProprietorNoEnumeration Date1/13/2014Last Updated1/15/2014Contact InformationPractice LocationPractice Address4208 Retama Cir, Victoria, TX 77901-2765Phone(361) 582-0611Fax(361) 582-0555Mailing LocationMailing Address4208 Retama Cir, Victoria, TX 77901-2765Phone(361) 582-0611Fax(361) 582-0555Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense1107324Texas