Provider Demographics
NPI:1205317401
Name:BIAS, KIMBERLY KAY (OTR)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:KAY
Last Name:BIAS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MRS
Other - First Name:KIMBERLY
Other - Middle Name:ANDERSON
Other - Last Name:BIAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:5623 WOOD WALK ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-5044
Mailing Address - Country:US
Mailing Address - Phone:210-867-6638
Mailing Address - Fax:
Practice Address - Street 1:855 E BASSE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1890
Practice Address - Country:US
Practice Address - Phone:210-930-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103895225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist