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General NPI Number Information
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NPI Number | 1396370003
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Entity Type | Individual
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Provider Name | KINGSLEY GEORGE IHEME FNP
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Gender | Male
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Dates
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Enumeration Date | 03/03/2020
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 1806 RUNNELS ST
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City | HARLINGEN
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State | TX
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Zip | 78550-8288
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Country | US
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Telephone | 956-230-3181
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Fax | 956-230-3182
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Provider Business Mailing Address
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Address Line | 7076 POST OAK CIR
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City | BROWNSVILLE
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State | TX
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Zip | 78526-3065
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Country | US
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Telephone | 832-457-1417
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | AP145205
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License Number State | TX
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