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General NPI Number Information
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NPI Number | 1003444274
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Entity Type | Individual
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Provider Name | TIMOTHY JOSEPH KIRTEK MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2020
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Last Update Date | 07/20/2025
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Provider Practice Location Address
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Address Line | 7777 FOREST LN STE C400
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City | DALLAS
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State | TX
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Zip | 75230-7516
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Country | US
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Telephone | 810-516-1285
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Fax |
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Provider Business Mailing Address
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Address Line | 300 PARK MEADOWS DR
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City | EULESS
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State | TX
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Zip | 76039-4338
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Country | US
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Telephone | 810-516-1285
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | V6336
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | V6336
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License Number State | TX
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