Kim D Georgiou, M.D.
Individual provider Active NPI Family Medicine Physician · Point Blank, TX
NPI 1083662670 · NPPES record last updated May 8, 2024
Key facts
- NPI
- 1083662670
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- N5074 (TX)
- Practice address
- 141 Fergerson Way
Point Blank, TX 77364 - Phone
- (512) 905-6889
- NPI assigned
- May 5, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060113000594 | TX | Practitioner - Family Practice | 2062435258 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5754 | AK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health and Human Services Commission | Current | Accepting new patients | |
| Health and Human Services Commission | Current |
Accepting new patients | |
| Health and Human Services Commission | Family Medicine | Current |
Accepting new patients |
| Jonathan a. Friedman, M.D., PLLC | Past | Accepting new patients | |
| St Joseph Physician Associates | Family Medicine | Past | Accepting new patients |
| Yolanda Marcos MD PA | Past |
Accepting new patients | |
| Hillside Primary Care PLLC | Past | Accepting new patients |
Locations
2501 Maple St
Abilene, TX 79602
Phone (325) 692-4053
4001 Highway 36 S
Brenham, TX 77833
Phone (979) 277-1327
6844 N US Highway 69
Pollok, TX 75969
Phone (936) 634-3353
2100 Preston St
Richmond, TX 77469
Phone (281) 232-2075
Interoperability endpoints
- kim.georgiou.1@13131.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD26996 | OR | |
| Family Medicine Physician | 207Q00000X | 5754 | AK | |
| Family Medicine Physician | 207Q00000X | N5074 | TX | Yes |
Addresses
Primary practice location
141 Fergerson Way
Point Blank, TX 77364
Mailing address
141 Ferguson Way
Pointblank, TX 77364-6581
Phone (713) 202-8289
Other practice location 1
510 Med Ct Ste 210
San Antonio, TX 78258-3484
Phone (210) 494-4290
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00358143 | Other | OR | RR MEDICARE |
Other providers in Point Blank, TX
All providers in Point Blank, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.