Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | MT194899 | PA |
Y | 2086S0129X | Vascular Surgeon | N9582 | TX |
NPI | 1043444565 |
---|---|
Provider Name | Dr. Melissa Louise Kirkwood |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2009 |
Last Update Date | 16/07/2011 |