Provider Demographics
NPI:1568400547
Name:OVALLE, KIMBERLY KAY (PA C)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:KAY
Last Name:OVALLE
Suffix:
Gender:F
Credentials:PA C
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Mailing Address - Street 1:915 GESSNER RD STE 750
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2574
Mailing Address - Country:US
Mailing Address - Phone:713-333-6900
Mailing Address - Fax:713-333-6919
Practice Address - Street 1:915 GESSNER RD STE 750
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2574
Practice Address - Country:US
Practice Address - Phone:713-333-6900
Practice Address - Fax:713-333-6919
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA04781363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant