Healthcare Provider Details

I. General information

NPI: 1407957939
Provider Name (Legal Business Name): KIMBERLY KAY SUMMERS PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 MERTON MINTER ST SOUTH TEXAS VETERANS HEALTH CARE SYSTEM
SAN ANTONIO TX
78229-4404
US

IV. Provider business mailing address

8206 HIGH CLIFF DR
FAIR OAKS RANCH TX
78015-4260
US

V. Phone/Fax

Practice location:
  • Phone: 210-617-5300
  • Fax: 210-949-3316
Mailing address:
  • Phone: 830-981-8229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number35622
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: