MEDICARE: KIM B RICHMOND MD

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	207L00000X	Anesthesiology Physician	H7646	TX

General Provider Information

NPI Number	:	1285695924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM B RICHMOND MD

Provider Business Mailing Address
First Line	:	5001 SPRING VALLEY RD
Second Line	:	SUITE 400 EAST
City	:	DALLAS
State	:	TX
Zip	:	75244-3946
Country	:	US
Telephone Number	:	817-529-2667
Fax Number	:

Provider Business Practice Location Address
First Line	:	5001 SPRING VALLEY RD
Second Line	:	SUITE 400 EAST
City	:	DALLAS
State	:	TX
Zip	:	75244-3946
Country	:	US
Telephone Number	:	817-529-2667
Fax Number	:

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	01/09/2009

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