Pershall, Kim E
Pershall, Kim E is an individual health care provider with primary practice located at 3811 24Th Street , Lubbock TX 79410-1813. He recently has 4 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Facial Plastic Surgery, Allopathic & Osteopathic Physicians / Otolaryngic Allergy. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Pershall, Kim E can be contacted via phone (806) 796-0202.Contact Information
Primary practice address
3811 24Th Street
Lubbock TX 79410-1813
Phone: (806) 796-0202
Fax: (806) 796-0496
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | J3574 | Texas |
| Other Service Providers / Specialist | 174400000X | 86103 | New Mexico |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | J3574 | Texas |
| Allopathic & Osteopathic Physicians / Facial Plastic Surgery | 207YS0123X | J3574 | Texas |
| Allopathic & Osteopathic Physicians / Otolaryngic Allergy | 207YX0602X | J3574 | Texas |
Profile Details
| NPI number | 1497751663 |
|---|---|
| LBN Legal business name | Pershall, Kim E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2005 |
| Last updated | Jan 31st, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497751663 | NPPES |
| Texas | Other | 121351100 | FIRSTCARE |
| Texas | MEDICAID | 034333701 | FIRSTCARE |
| Texas | Other | 8P8420 | FIRSTCARE |
| Texas | MEDICAID | 37234 | FIRSTCARE |
| Texas | Other | 8F21125 | FIRSTCARE |
| Texas | Other | 148127701 | FIRSTCARE |
| Texas | Other | 040007969 | FIRSTCARE |
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