Provider Demographics
NPI:1689820599
Name:KAMMERER, KRISTEN LINNEA (DO)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:LINNEA
Last Name:KAMMERER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:LINNEA
Other - Last Name:BICKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1920 N COIT RD STE 200-122
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2832
Mailing Address - Country:US
Mailing Address - Phone:729-244-3142
Mailing Address - Fax:
Practice Address - Street 1:7814 LA CABEZA DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-3127
Practice Address - Country:US
Practice Address - Phone:734-730-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6213208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics