Provider Demographics
NPI:1154302644
Name:BEST, KIM DONALD (PA CW-2 RET)
Entity Type:Individual
Prefix:MR
First Name:KIM
Middle Name:DONALD
Last Name:BEST
Suffix:
Gender:M
Credentials:PA CW-2 RET
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Mailing Address - Street 1:20290 S. FM 92
Mailing Address - Street 2:BOX 337
Mailing Address - City:FRED
Mailing Address - State:TX
Mailing Address - Zip Code:77616-0337
Mailing Address - Country:US
Mailing Address - Phone:409-429-9494
Mailing Address - Fax:409-980-9457
Practice Address - Street 1:20290 S. FM 92
Practice Address - Street 2:BOX 337
Practice Address - City:FRED
Practice Address - State:TX
Practice Address - Zip Code:77616-0337
Practice Address - Country:US
Practice Address - Phone:409-429-9494
Practice Address - Fax:409-980-9457
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2007-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA01332363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX673899Medicare PIN
TXS09777Medicare UPIN
TX673899Medicare Oscar/Certification