Healthcare Provider Details

I. General information

NPI: 1124475926
Provider Name (Legal Business Name): KIMBERLY S. BARRON D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2016
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S ZARZAMORA ST
SAN ANTONIO TX
78207-5209
US

IV. Provider business mailing address

701 S ZARZAMORA ST
SAN ANTONIO TX
78207-5209
US

V. Phone/Fax

Practice location:
  • Phone: 210-358-7717
  • Fax: 210-358-7707
Mailing address:
  • Phone: 210-358-7717
  • Fax: 210-358-7707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36003910
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number692099
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number692099
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: