Kimberly Annette Allen, MASSAGE THERAPIST
Individual provider Active NPI Contractor · Sweeny, TX
NPI 1114163409 · NPPES record last updated Dec 17, 2008
Key facts
- NPI
- 1114163409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- MT033206 (TX)
- Practice address
- 4768 County Road 502B
Sweeny, TX 77480-8119 - Phone
- (979) 236-3021
- Fax
- (979) 548-4808
- NPI assigned
- Dec 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT033206 | TX | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | MT033206 | TX | Yes |
Addresses
Primary practice location
4768 County Road 502B
Sweeny, TX 77480-8119
Mailing address
4768 County Road 502B
Sweeny, TX 77480-8119
Phone (979) 236-3021
Other providers in Sweeny, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.