Provider Demographics
NPI:1740484344
Name:CARPIN, KIMBERLY MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:MARIE
Last Name:CARPIN
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 1:2020 NASA PKWY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3683
Mailing Address - Country:US
Mailing Address - Phone:281-333-4600
Mailing Address - Fax:281-333-9455
Practice Address - Street 1:2020 NASA PKWY
Practice Address - Street 2:SUITE 260
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3683
Practice Address - Country:US
Practice Address - Phone:281-333-4600
Practice Address - Fax:281-333-9455
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-00222222086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX329844001Medicaid
2777194415OtherMYUTMB 2777194415-COMMERCIAL NUMBER
TX289818YVIWMedicare PIN