Khidja Seymour
Procedural Dermatology
5288 Trail Lake Dr Ste 13
Fort Worth
, Texas 76133-1939
Khidja Seymour
Procedural Dermatology
5288 Trail Lake Dr Ste 13
Fort Worth
, Texas 76133-1939
(817) 917-6181
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About
Features
Specialties
- Procedural Dermatology
Languages spoken
- English
Location
First Address
- Khidja Seymour
- 2915 Jonah Dr Apt 118
- Fort Worth, TX
- Zip : 76108-5937
- Phone : (817) 917-6181
Second Address
- Khidja Seymour
- 5288 Trail Lake Dr Ste 13
- Fort Worth, TX
- Zip : 76133-1939
- Phone : (817) 917-6181
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207NS0135X | Procedural Dermatology | KK307596 | CA |
| Y | 207NS0135X | Procedural Dermatology | KK37596 | CA |
National Provider Identifier
| NPI | 1548777683 |
|---|---|
| Provider Name | Khidja Seymour |
| First Address | Fort Worth, TX 76108-5937 |
| Second Address | Fort Worth, TX 76133-1939 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/01/2018 |
| Last Update Date | 16/06/2018 |
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.