Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | J3282 | TX |
NPI | 1033104567 |
---|---|
Provider Name | Dr. Kimberly Kaye Brady |
First Address | Houston, TX 77024-2301 |
Second Address | Houston, TX 77024-2301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F97096 | (02) | TX |