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General NPI Number Information
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NPI Number | 1720048614
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Entity Type | Individual
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Provider Name | SANDRA KITSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 556 N LOOP 340
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City | BELLMEAD
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State | TX
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Zip | 76705-2572
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Country | US
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Telephone | 254-799-3690
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 847408
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City | DALLAS
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State | TX
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Zip | 75284-7408
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Country | US
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Telephone | 254-724-2111
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M2370
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License Number State | TX
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