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General NPI Number Information
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NPI Number | 1871488213
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Entity Type | Individual
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Provider Name | BROOKE KIESLING AUD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 5751 EDWARDS RANCH RD STE 200
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City | FORT WORTH
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State | TX
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Zip | 76109-4152
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Country | US
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Telephone | 817-678-5242
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Fax |
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Provider Business Mailing Address
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Address Line | 10733 LIPAN TRL
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City | FORT WORTH
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State | TX
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Zip | 76108-6924
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Country | US
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Telephone |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 81799
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License Number State | TX
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