Provider Demographics
NPI:1588855761
Name:COONFIELD, KIMBERLY VOGEL (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:VOGEL
Last Name:COONFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2520 B F TERRY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-5636
Mailing Address - Country:US
Mailing Address - Phone:281-342-6006
Mailing Address - Fax:281-239-7554
Practice Address - Street 1:2100 REGIONAL MEDICAL DR
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488
Practice Address - Country:US
Practice Address - Phone:979-532-1700
Practice Address - Fax:979-532-4584
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4995207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX215204301Medicaid
TX215204305Medicaid
TX8DE522OtherBC/BS #
TXP00896923OtherRAILROAD-MEDICARE #
TXP01090444OtherRAILROAD MEDICARE PTAN
TX8DE522OtherBC/BS #
TX215204301Medicaid