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General NPI Number Information
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NPI Number | 1942539606
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Entity Type | Organization
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Legal Business Name | KIMBERLEA A ROE, M.D., P.A.
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Dates
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Enumeration Date | 12/09/2009
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 418 N MONTCLAIR AVE
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City | DALLAS
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State | TX
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Zip | 75208-5447
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Country | US
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Telephone | 214-478-2221
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Fax |
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Provider Business Mailing Address
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Address Line | 418 N MONTCLAIR AVE
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City | DALLAS
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State | TX
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Zip | 75208-5447
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Country | US
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Telephone | 214-478-2221
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | KIMBERLEA A ROE
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Credential | M.D.
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Telephone | 214-478-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | K2112
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License Number State | TX
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