Healthcare Provider Details

I. General information

NPI: 1922916873
Provider Name (Legal Business Name): KIMBERLY DUMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27440 SOUTHLAND DR
SPLENDORA TX
77372-4410
US

IV. Provider business mailing address

27440 SOUTHLAND DR
SPLENDORA TX
77372-4410
US

V. Phone/Fax

Practice location:
  • Phone: 281-622-9076
  • Fax:
Mailing address:
  • Phone: 281-622-9076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number101561
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: