Provider Demographics
NPI:1457619595
Name:KIMIAGAREE, MAURICE (MD)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:
Last Name:KIMIAGAREE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 CREEKSIDE XING
Mailing Address - Street 2:RESOLUTE HEALTH HOSPITAL
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2594
Mailing Address - Country:US
Mailing Address - Phone:830-500-6000
Mailing Address - Fax:
Practice Address - Street 1:555 CREEKSIDE XING
Practice Address - Street 2:RESOLUTE HEALTH HOSPITAL
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2594
Practice Address - Country:US
Practice Address - Phone:830-500-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ4789207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program