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NPI Code Detail

MEDICARE: KIRBY TINSLEY PA-C

MEDICARE:   KIRBY  TINSLEY  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA09201TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
38610NQOTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1023425147
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRBY TINSLEY PA-C
Provider Business Mailing Address
First Line : 8808 CAMP BOWIE WEST BLVD
Second Line : SUIT 140
City : FORT WORTH
State : TX
Zip : 76116-6028
Country : US
Telephone Number : 806-584-0124
Fax Number :
Provider Business Practice Location Address
First Line : 8808 CAMP BOWIE WEST BLVD
Second Line : SUIT 140
City : FORT WORTH
State : TX
Zip : 76116-6028
Country : US
Telephone Number : 806-584-0124
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2014
Last Update Date : 12/03/2015

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Directions to “ KIRBY TINSLEY PA-C” Practice Location

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