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General NPI Number Information
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NPI Number | 1093145971
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Entity Type | Individual
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Provider Name | KIMBERLY DOERING PTA
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Gender | Female
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Dates
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Enumeration Date | 11/14/2013
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 8306 HUEBNER RD
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1864
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Country | US
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Telephone | 210-691-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 104 LINA LN
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City | BOERNE
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State | TX
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Zip | 78015-4776
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Country | US
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Telephone | 914-475-3977
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2099181
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 008859-1
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License Number State | NY
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