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General NPI Number Information
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NPI Number | 1427343367
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Entity Type | Individual
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Provider Name | KIRSTIN KIMBERLY O'LEARY D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2011
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 5010 GARTH RD STE 204
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City | BAYTOWN
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State | TX
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Zip | 77521-2254
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Country | US
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Telephone | 281-421-4867
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Fax |
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Provider Business Mailing Address
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Address Line | 7171 BUFFALO SPEEDWAY APT 318
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City | HOUSTON
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State | TX
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Zip | 77025-1426
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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 |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 26543
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License Number State | TX
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