MEDICARE: DR. KIMBERLY PROCELL M.D.

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	208000000X	Pediatrics Physician	M1298	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00M37MT	OTHER	TX	BLUE CROSS

General Provider Information

NPI Number	:	1699734103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY PROCELL M.D.

Provider Business Mailing Address
First Line	:	615 RUSSELL BLVD
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1247
Country	:	US
Telephone Number	:	936-564-1740
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 RUSSELL BLVD
Second Line	:
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1247
Country	:	US
Telephone Number	:	936-564-1740
Fax Number	:

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

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	06/12/2024

Similar Medicare Providers

1407084114 — DR. RACHEL B HEAD MD
Practice Location Address:

617 RUSSELL BLVD
NACOGDOCHES, TX
75965-1247

Practice Phone: 936-305-5109
Practice Fax: 936-305-5112

1598373144 — MUHAMMAD QUDRAT ULLAH MD
Practice Location Address:

623 RUSSELL BLVD
NACOGDOCHES, TX
75965-1247

Practice Phone: 936-260-7801
Practice Fax:

1730797390 — ANOSHA ANWAR MD
Practice Location Address:

623 RUSSELL BLVD
NACOGDOCHES, TX
75965-1247

Practice Phone: 936-260-7801
Practice Fax:

1346246964 — DR. KAVITA S VYAS M.D.
Practice Location Address:

607 RUSSELL BLVD , A
NACOGDOCHES, TX
75965-1247

Practice Phone: 936-560-2920
Practice Fax: 866-861-6312

1841248630 — NACOGDOCHES MEDICAL CLINIC PLLC
Practice Location Address:

607 RUSSELL BLVD , A
NACOGDOCHES, TX
75965-1247

Practice Phone: 936-560-2920
Practice Fax: 866-861-6312

1881646131 — CHERYL G. SCALORA CNM
Practice Location Address:

623 RUSSELL BLVD
NACOGDOCHES, TX
75965-1247

Practice Phone: 936-305-5277
Practice Fax: 866-859-9363

Directions to “ DR. KIMBERLY PROCELL M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.