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General NPI Number Information
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NPI Number | 1518138650
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Entity Type | Organization
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Legal Business Name | ORVIL V KIMBALL JR
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 4415 CRENSHAW RD
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City | PASADENA
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State | TX
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Zip | 77504-3628
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Country | US
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Telephone | 281-998-0500
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Fax | 281-998-1689
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Provider Business Mailing Address
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Address Line | 4415 CRENSHAW RD
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City | PASADENA
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State | TX
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Zip | 77504-3628
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Country | US
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Telephone | 281-998-0500
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Fax | 281-998-1689
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | ORVIL V KIMBALL JR.
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Credential | O.D.
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Telephone | 281-998-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2845TG
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License Number State | TX
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