Provider Demographics
NPI:1720539794
Name:BISON, KIER (PHD)
Entity Type:Individual
Prefix:DR
First Name:KIER
Middle Name:
Last Name:BISON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 LEGACY DR
Mailing Address - Street 2:SUITE 1124
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6066
Mailing Address - Country:US
Mailing Address - Phone:469-888-5217
Mailing Address - Fax:469-888-5198
Practice Address - Street 1:2990 LEGACY DR
Practice Address - Street 2:SUITE 1124
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6066
Practice Address - Country:US
Practice Address - Phone:469-888-5217
Practice Address - Fax:469-888-5198
Is Sole Proprietor?:No
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25811103G00000X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist