Provider Demographics
NPI:1871245415
Name:TINH, KRISTIE
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:TINH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 797171
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-7171
Mailing Address - Country:US
Mailing Address - Phone:214-494-4424
Mailing Address - Fax:214-494-4423
Practice Address - Street 1:7000 PARKWOOD BLVD STE F100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7407
Practice Address - Country:US
Practice Address - Phone:214-494-4424
Practice Address - Fax:214-494-4423
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10589122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology