Provider Demographics
NPI:1669787131
Name:BILLET, KIMBERLY ANN WERNER (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANN WERNER
Last Name:BILLET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:WERNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4645 AVON LN STE 375
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1216
Mailing Address - Country:US
Mailing Address - Phone:469-922-3376
Mailing Address - Fax:469-922-3222
Practice Address - Street 1:4645 AVON LN STE 375
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1216
Practice Address - Country:US
Practice Address - Phone:469-922-3376
Practice Address - Fax:469-922-3222
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101250207207N00000X, 208D00000X
FLME135731207N00000X
390200000X
TXS0590207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program