MEDICARE: PAUL KINBERG D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	503	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	H08CG41801	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1285637876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL KINBERG D.P.M.

Provider Business Mailing Address
First Line	:	1151 N BUCKNER BLVD
Second Line	:	STE 304
City	:	DALLAS
State	:	TX
Zip	:	75218-3405
Country	:	US
Telephone Number	:	214-826-0111
Fax Number	:	877-631-1566

Provider Business Practice Location Address
First Line	:	1151 N BUCKNER BLVD
Second Line	:	STE 304
City	:	DALLAS
State	:	TX
Zip	:	75218-3405
Country	:	US
Telephone Number	:	214-826-0111
Fax Number	:	877-631-1566

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	02/22/2013

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