Healthcare Provider Details

I. General information

NPI: 1255789962
Provider Name (Legal Business Name): KIMBERLY CHOU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4316 JAMES CASEY ST STE B-100
AUSTIN TX
78745-1142
US

IV. Provider business mailing address

PO BOX 3409
PFLUGERVILLE TX
78691-3409
US

V. Phone/Fax

Practice location:
  • Phone: 512-444-4325
  • Fax:
Mailing address:
  • Phone: 512-202-3830
  • Fax: 512-354-1106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS5142
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberS5142
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: