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NPI Code Detail

MEDICARE: KIMBERLY IMOH MD

MEDICARE: KIMBERLY IMOH MD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1619811304
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY IMOH MD
Provider Business Mailing Address
First Line : 4835 KNIGHTS BRANCH DR
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-5338
Country : US
Telephone Number : 346-404-9706
Fax Number :
Provider Business Practice Location Address
First Line : 5323 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-648-3433
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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Directions to “ KIMBERLY IMOH MD” Practice Location

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