MEDICARE: DR. PATRICIA J KIMES DDS

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	1223G0001X	General Practice Dentistry	0023285	TX

General Provider Information

NPI Number	:	1225231418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA J KIMES DDS

Provider Business Mailing Address
First Line	:	11420 BEE CAVES RD
Second Line	:	SUITE B-150
City	:	AUSTIN
State	:	TX
Zip	:	78738-5526
Country	:	US
Telephone Number	:	512-263-8500
Fax Number	:	512-263-2866

Provider Business Practice Location Address
First Line	:	11420 BEE CAVES RD
Second Line	:	SUITE B-150
City	:	AUSTIN
State	:	TX
Zip	:	78738-5526
Country	:	US
Telephone Number	:	512-263-8500
Fax Number	:	512-263-2866

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

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	12/31/2012

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