MEDICARE: KIMBERLY CARTER

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	163WA2000X	Administrator Registered Nurse	842337	TX

General Provider Information

NPI Number	:	1235091034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY CARTER

Provider Business Mailing Address
First Line	:	4503 CROSLEY FIELD DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-5307
Country	:	US
Telephone Number	:	713-804-9123
Fax Number	:

Provider Business Practice Location Address
First Line	:	3521 GRASSMERE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-3256
Country	:	US
Telephone Number	:	713-804-9123
Fax Number	:

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

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ KIMBERLY CARTER ” Practice Location

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