Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1172989 | TX |
NPI | 1043433311 |
---|---|
Provider Name | Mrs. Kimberly Cox Mayfield |
First Address | Arlington, TX 76006-6632 |
Second Address | Dallas, TX 75212-6313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |