Provider Demographics
NPI:1285045369
Name:KIMBELL, LISA PAUL (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:PAUL
Last Name:KIMBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14090 FM 2920 RD STE G360
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-5549
Mailing Address - Country:US
Mailing Address - Phone:979-292-4729
Mailing Address - Fax:
Practice Address - Street 1:14090 FM 2920 RD STE G360
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-5549
Practice Address - Country:US
Practice Address - Phone:979-292-4729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS8592207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology