Provider Demographics
NPI:1124022405
Name:KING, KAREN KAY (DO)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:KAY
Last Name:KING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9323 GARLAND RD
Mailing Address - Street 2:STE 111
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3693
Mailing Address - Country:US
Mailing Address - Phone:214-328-7400
Mailing Address - Fax:214-328-7680
Practice Address - Street 1:9323 GARLAND RD
Practice Address - Street 2:STE 111
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3693
Practice Address - Country:US
Practice Address - Phone:214-328-7400
Practice Address - Fax:214-328-7680
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH0522207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AJ718OtherBCBS
TX8F8159OtherMEDICARE INDIVIDUAL PTAN
TX126914403Medicaid
TXS0062987OtherDPS
TXBK0494360OtherDEA
TXBK0494360OtherDEA