Dr. Kim E Pershall
Otolaryngologist (ENT Doctor) Facial Plastic Surgeon
3811 24th Street
Lubbock
, Texas 79410-1813
Dr. Kim E Pershall
Otolaryngologist (ENT Doctor) Facial Plastic Surgeon
3811 24th Street
Lubbock
, Texas 79410-1813
(806) 796-0496
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
- Facial Plastic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Kim E Pershall
- 3811 24th Street
- Lubbock, TX
- Zip : 79410-1813
- Fax : (806) 796-0496
- Phone : (806) 796-0202
Second Address
- Dr. Kim E Pershall
- 3811 24th Street
- Lubbock, TX
- Zip : 79410-1813
- Fax : (806) 796-0496
- Phone : (806) 796-0202
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngologist (ENT Doctor) | J3574 | TX |
| N | 207YS0123X | Facial Plastic Surgeon | J3574 | TX |
National Provider Identifier
| NPI | 1497751663 |
|---|---|
| Provider Name | Dr. Kim E Pershall |
| First Address | Lubbock, TX 79410-1813 |
| Second Address | Lubbock, TX 79410-1813 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/06/2005 |
| Last Update Date | 31/01/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 034333701 | (05) | TX |
| 040007969 | RAILROAD MEDICARE (01) | TX |
| 121351100 | FIRSTCARE (01) | TX |
| 148127701 | MEDICAID GROUP (01) | TX |
| 37234 | (05) | NM |
| 8F21125 | MEDICARE PTAN (01) | TX |
| 8P8420 | BCBS TX (01) | TX |
| C98030 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.