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General NPI Number Information
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NPI Number | 1952923872
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Entity Type | Individual
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Provider Name | KIMBERLY COSBY R. EEG TECH
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Gender | Female
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Dates
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Enumeration Date | 05/13/2020
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 6565 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-2703
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Country | US
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Telephone | 281-441-3078
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Fax |
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Provider Business Mailing Address
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Address Line | 1816 LONG OAK DR
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City | PEARLAND
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State | TX
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Zip | 77581-4694
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Country | US
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Telephone | 346-802-1161
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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 | 246ZE0500X
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Taxonomy Name | EEG Specialist/Technologist
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License Number | 4078
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License Number State | MN
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