Provider Demographics
NPI:1518559582
Name:AZCARATE - SILVA, KIMBERLEY NICHOLE (DC)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:NICHOLE
Last Name:AZCARATE - SILVA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7979 INWOOD RD STE 123
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-3377
Mailing Address - Country:US
Mailing Address - Phone:214-902-0092
Mailing Address - Fax:
Practice Address - Street 1:7979 INWOOD RD STE 123
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-3377
Practice Address - Country:US
Practice Address - Phone:214-902-0092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor