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General NPI Number Information
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NPI Number | 1396627378
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Entity Type | Organization
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Legal Business Name | KINGDOM RECOVERY AND INJURY
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 10550 PLANO RD
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City | DALLAS
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State | TX
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Zip | 75238-1306
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Country | US
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Telephone | 214-810-4124
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Fax | 214-387-1232
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Provider Business Mailing Address
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Address Line | 342 ASH BROOK LN
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City | SUNNYVALE
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State | TX
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Zip | 75182-3251
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Country | US
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Telephone | 214-803-0768
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE NEWTON
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Credential | NP
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Telephone | 214-810-4124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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