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General NPI Number Information
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NPI Number | 1932464393
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Entity Type | Individual
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Provider Name | KATHRYN KIMBROUGH GENGLER M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 301 UNIVERSITY BLVD DEPARTMENT OF SURGERY RTE. 0724
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City | GALVESTON
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State | TX
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Zip | 77555
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Country | US
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Telephone | 409-772-1369
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Fax |
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Provider Business Mailing Address
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Address Line | 6035 DEREK TRL
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City | DALLAS
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State | TX
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Zip | 75252-2371
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | BP10044575
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | R5863
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License Number State | TX
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