Kimberly Udell D.O., P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

L1225 Issued in TX

Legal business name

KIMBERLY UDELL D.O., P.A.

Practice address

3602 Matlock Rd Ste 206
Arlington, TX 76015-3600

Phone

(817) 468-1506

Fax

(817) 468-1520

NPI assigned

Sep 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kimberly Udell, D.O.NPI 1619059201

Title

Physician

Phone

(817) 468-1506

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Udell, D.O.

  • Gynecology Physician
  • Arlington, TX
  • NPI 1619059201
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1013103191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3602 MATLOCK RD STE 206",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760153600",
            "telephone_number": "817-468-1506",
            "fax_number": "817-468-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 MATLOCK RD STE 206",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760153600",
            "telephone_number": "817-468-1506",
            "fax_number": "817-468-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY UDELL D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "UDELL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "817-468-1506",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "L1225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165666201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8P5630",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ji Yoon Kim, DDS
• Julie Yunji Kim, AGPCNP-BC
• Peter Kim, MD
• Suyeon Kim
• Yana Kim
• Kind Loving Care, LLC
• Kinetic Balance Therapeutic Massage LLP
• Kineticare Rehab Services P.C.
• Colleen King
• Illya King, L.V.N.

• Specialist in Arlington, TX
• Providers in Arlington, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.