Provider Demographics
NPI:1912267048
Name:KIM ROBINSON PLLC
Entity Type:Organization
Organization Name:KIM ROBINSON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:940-761-9700
Mailing Address - Street 1:1101 SCOTT AVE
Mailing Address - Street 2:SUITE 27
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-4671
Mailing Address - Country:US
Mailing Address - Phone:940-761-9700
Mailing Address - Fax:940-761-9704
Practice Address - Street 1:1101 SCOTT AVE
Practice Address - Street 2:SUITE 27
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4671
Practice Address - Country:US
Practice Address - Phone:940-761-9700
Practice Address - Fax:940-761-9704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36118103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty