Provider Demographics
NPI:1013010206
Name:KIMBROUGH, FRANCES HARRIETT (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:HARRIETT
Last Name:KIMBROUGH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 SOUTH HOUSTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77803
Mailing Address - Country:US
Mailing Address - Phone:979-775-9406
Mailing Address - Fax:
Practice Address - Street 1:403 SOUTH HOUSTON AVENUE
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77803
Practice Address - Country:US
Practice Address - Phone:979-775-9406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22689103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQH92OtherBLUE CROSS BLUE SHIELD