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General NPI Number Information
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NPI Number | 1417984055
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Entity Type | Individual
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Provider Name | KAREN M KIRK MD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 701 INTERSTATE 20 E
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City | ARLINGTON
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State | TX
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Zip | 76018-1130
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Country | US
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Telephone | 817-852-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 S MAIN ST
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City | FORT WORTH
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State | TX
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Zip | 76104-4917
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Country | US
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Telephone | 817-921-3431
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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 | 2080S0010X
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Taxonomy Name | Pediatric Sports Medicine Physician
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License Number | L9289
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License Number State | TX
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