Provider Demographics
NPI:1841289667
Name:KINSELLA, VIRGINIA MACHADO (MD)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:MACHADO
Last Name:KINSELLA
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:3705 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7753
Practice Address - Country:US
Practice Address - Phone:972-867-3577
Practice Address - Fax:972-985-9433
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9765207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167747804Medicaid
TX167747803Medicaid
TX167747808Medicaid
TX167747807Medicaid
TXI18839Medicare UPIN
TX167747804Medicaid
TX8J2245Medicare PIN
TX167747808Medicaid
TX8J2250Medicare PIN