MEDICARE: DR. TIMOTHY CHARLES KIRKPATRICK D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	DN12164	FL
2	1223E0200X	Endodontics	15921	TX

General Provider Information

NPI Number	:	1134190515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY CHARLES KIRKPATRICK D.D.S.

Provider Business Mailing Address
First Line	:	14103 WINDY CRK
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-4274
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 CAMBRIDGE ST STE 3410
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2032
Country	:	US
Telephone Number	:	713-486-4227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	04/11/2023

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