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General NPI Number Information
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NPI Number | 1821433004
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Entity Type | Organization
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Legal Business Name | ADEAN KINGSTON MD PLLC
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Dates
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Enumeration Date | 05/01/2013
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Last Update Date | 05/01/2013
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Provider Practice Location Address
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Address Line | 4514 COLE AVE SUITE 910
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City | DALLAS
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State | TX
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Zip | 75205-5412
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Country | US
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Telephone | 214-420-3376
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Fax | 214-420-3630
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Provider Business Mailing Address
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Address Line | 4514 COLE AVE SUITE 910
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City | DALLAS
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State | TX
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Zip | 75205-5412
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Country | US
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Telephone | 214-420-3376
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Fax | 214-420-3630
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Authorized Official
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Title or Position | OWNER
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Name | ADEAN AUDACE KINGSTON
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Credential | MD
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Telephone | 214-420-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | N0170
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License Number State | TX
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