Provider Demographics
NPI:1396989034
Name:WASHINGTON, KIMBERLY LATOYA (MD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:LATOYA
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 PENNSYLVANIA AVE STE 560
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2152
Mailing Address - Country:US
Mailing Address - Phone:817-250-7240
Mailing Address - Fax:888-977-1985
Practice Address - Street 1:1325 PENNSYLVANIA AVE STE 560
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2152
Practice Address - Country:US
Practice Address - Phone:817-250-7240
Practice Address - Fax:888-977-1985
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9131204F00000X, 208600000X
ORMD198047208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery