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General NPI Number Information
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NPI Number | 1518245521
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Entity Type | Organization
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Legal Business Name | KIMBERLY KJOME, MD, PA
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Dates
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Enumeration Date | 07/25/2011
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Last Update Date | 07/25/2011
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Provider Practice Location Address
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Address Line | 2911 MEDICAL ARTS ST BUILDING 7
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City | AUSTIN
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State | TX
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Zip | 78705-3376
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Country | US
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Telephone | 512-391-1501
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Fax | 512-391-1502
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Provider Business Mailing Address
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Address Line | 2911 MEDICAL ARTS ST BUILDING 7
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City | AUSTIN
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State | TX
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Zip | 78705-3376
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Country | US
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Telephone | 512-391-1501
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Fax | 512-391-1502
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KIMBERLY LEIGH KJOME
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Credential | M.D.
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Telephone | 512-391-1501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | M7336
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License Number State | TX
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