Provider Demographics
NPI:1225231418
Name:KIMES, PATRICIA J (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:J
Last Name:KIMES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11420 BEE CAVES RD
Mailing Address - Street 2:SUITE B-150
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-5526
Mailing Address - Country:US
Mailing Address - Phone:512-263-8500
Mailing Address - Fax:512-263-2866
Practice Address - Street 1:11420 BEE CAVES RD
Practice Address - Street 2:SUITE B-150
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-5526
Practice Address - Country:US
Practice Address - Phone:512-263-8500
Practice Address - Fax:512-263-2866
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00232851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice