Healthcare Provider Details

I. General information

NPI: 1366487159
Provider Name (Legal Business Name): KIMBERLY KARLA SWEET M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 S MIDLOTHIAN PKWY SUITE 100
MIDLOTHIAN TX
76065-5591
US

IV. Provider business mailing address

1441 S MIDLOTHIAN PKWY SUITE 100
MIDLOTHIAN TX
76065-5591
US

V. Phone/Fax

Practice location:
  • Phone: 972-723-1474
  • Fax: 972-723-9423
Mailing address:
  • Phone: 972-723-1474
  • Fax: 972-723-9423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL2021
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: