Provider Demographics
NPI:1720291859
Name:KIRBY, JUDITH A (MD, FACS)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:KIRBY
Suffix:
Gender:F
Credentials:MD, FACS
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:A
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10740 N CENTRAL EXPY STE 250
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-2142
Mailing Address - Country:US
Mailing Address - Phone:214-253-0202
Mailing Address - Fax:214-253-0203
Practice Address - Street 1:10740 N CENTRAL EXPY STE 250
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2161
Practice Address - Country:US
Practice Address - Phone:214-253-0202
Practice Address - Fax:214-253-0203
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8274207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG06748Medicare UPIN