Provider Demographics
NPI:1114908753
Name:MONDAY, KIMBERLY E (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:E
Last Name:MONDAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 FANNIN ST STE 1014
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-5301
Mailing Address - Country:US
Mailing Address - Phone:832-325-7080
Mailing Address - Fax:713-512-2239
Practice Address - Street 1:6410 FANNIN ST STE 1014
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:832-325-7080
Practice Address - Fax:713-512-2239
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ43642084N0600X, 2084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0035TDOtherBLUE CROSS BLUE SHIELD OF TEXAS GROUP RECORD NUMBER
TX00X185OtherMEDICARE GROUP PTAN - BRAZORIA
TX153449704OtherMEDICAID GROUP TPI
TX8DC610OtherBLUE CROSS BLUE SHIELD OF TEXAS INDIVIDUAL RECORD NUMBER
DB6392OtherRAILROAD MEDICARE GROUP PTAN
TX00106WOtherMEDICARE GROUP PTAN - HARRIS
TXTXB147922Medicare PIN
TX00X185OtherMEDICARE GROUP PTAN - BRAZORIA
TXTXB150043Medicare PIN