MEDICARE: KIMBERLY BURRELL

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1134713167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY BURRELL

Provider Business Mailing Address
First Line	:	27708 TOMBALL PKWY # 1044
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77375-6472
Country	:	US
Telephone Number	:	832-229-1744
Fax Number	:

Provider Business Practice Location Address
First Line	:	10822 TRAIL RIDGE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77064-5129
Country	:	US
Telephone Number	:	832-229-1744
Fax Number	:

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

Provider Enumeration Date	:	02/20/2021
Last Update Date	:	02/20/2021

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Directions to “ KIMBERLY BURRELL ” Practice Location

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