=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386537231
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KIRKWOOD PRIMARY CARE AND WELLNESS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2025
-----------------------------------------------------
Last Update Date | 10/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11003 RESOURCE PKWY STE 106
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77089-6142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-310-1326
-----------------------------------------------------
Fax | 855-538-0813
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11003 RESOURCE PKWY STE 106
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77089-6142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-310-1326
-----------------------------------------------------
Fax | 855-538-0813
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN/OWNER
-----------------------------------------------------
Name | TOBY KIRKWOOD
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 281-310-1326
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------