Provider Demographics
NPI:1497915888
Name:DIMEOLA, ASHLEY KLEIN (DO)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:KLEIN
Last Name:DIMEOLA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:BROOKE
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:7620 DEER RUN
Mailing Address - Street 2:
Mailing Address - City:VOLENTE
Mailing Address - State:TX
Mailing Address - Zip Code:78641-6108
Mailing Address - Country:US
Mailing Address - Phone:512-291-7493
Mailing Address - Fax:888-592-7303
Practice Address - Street 1:7620 DEER RUN
Practice Address - Street 2:
Practice Address - City:VOLENTE
Practice Address - State:TX
Practice Address - Zip Code:78641-6108
Practice Address - Country:US
Practice Address - Phone:512-291-7493
Practice Address - Fax:888-592-7303
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXP6965207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program