Provider Demographics
NPI:1013111343
Name:DOBBINS, KIMBERLY MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:MICHELLE
Last Name:DOBBINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:MICHELLE
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2150 LAKESIDE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4302
Mailing Address - Country:US
Mailing Address - Phone:972-437-4698
Mailing Address - Fax:972-671-2087
Practice Address - Street 1:2150 LAKESIDE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4302
Practice Address - Country:US
Practice Address - Phone:972-437-4698
Practice Address - Fax:972-671-2087
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM79152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0022490OtherINSTITUTIONAL PERMIT