MEDICARE: KIM MARIE BAPTISTE

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1215698303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM MARIE BAPTISTE

Provider Business Mailing Address
First Line	:	712 WILCREST DR # 1006
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-1348
Country	:	US
Telephone Number	:	979-472-1394
Fax Number	:	281-529-7815

Provider Business Practice Location Address
First Line	:	712 WILCREST DR # 1006
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-1348
Country	:	US
Telephone Number	:	979-472-1394
Fax Number	:	281-529-7815

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

Provider Enumeration Date	:	01/01/2022
Last Update Date	:	01/01/2022

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