Provider Demographics
NPI:1528043221
Name:KIRKWOOD, RONALD W (DO)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:W
Last Name:KIRKWOOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4001 PRESTON AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-2019
Mailing Address - Country:US
Mailing Address - Phone:281-249-2251
Mailing Address - Fax:281-249-2282
Practice Address - Street 1:4001 PRESTON AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-2019
Practice Address - Country:US
Practice Address - Phone:281-249-2251
Practice Address - Fax:281-249-2282
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2007-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH4467207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F2858Medicare PIN
TXA67279Medicare UPIN