MEDICARE: MS. KATHLEEN J KIMBERLIN OTR

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
1	225XH1200X	Hand Occupational Therapist	109107	TX

General Provider Information

NPI Number	:	1114124526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN J KIMBERLIN OTR

Provider Business Mailing Address
First Line	:	25414 SPRING RIDGE DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1510
Country	:	US
Telephone Number	:	832-275-6111
Fax Number	:	281-857-6487

Provider Business Practice Location Address
First Line	:	3915 SHAVER ST
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-2603
Country	:	US
Telephone Number	:	713-378-0030
Fax Number	:	713-378-0399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	07/08/2007

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