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General NPI Number Information
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NPI Number | 1598482788
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Entity Type | Individual
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Provider Name | KIMBERLY R. ROCHA PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 2200 HUGHES ST
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City | MIDLAND
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State | TX
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Zip | 79705-8334
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Country | US
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Telephone | 253-208-0381
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 N MIDLAND DR STE 406
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City | MIDLAND
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State | TX
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Zip | 79707-3388
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Country | US
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Telephone | 432-704-5661
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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 | 225500000X
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Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA17349
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License Number State | TX
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