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General NPI Number Information
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NPI Number | 1104611565
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Entity Type | Organization
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Legal Business Name | KIBLE HEALTH TX, P.A.
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 7 BRIERCROFT OFFICE PARK FL 2
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City | LUBBOCK
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State | TX
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Zip | 79412-3023
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Country | US
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Telephone | 646-396-0527
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Fax |
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Provider Business Mailing Address
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Address Line | 390 NE 191ST ST STE 8885
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City | MIAMI
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State | FL
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Zip | 33179-3899
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CAO
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Name | SAMANTHA WU
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Credential |
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Telephone | 209-671-7101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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