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Organization
KIDD MEDICAL CONCEPTS PLLC
Active
Organization
KIDD MEDICAL CONCEPTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AVIAN DESHIVER KIDD MD (PRESIDENT & PROVIDER)
(972) 505-1584
Entity
Organization
Contact information
Practice address
2900 MCKINNON ST APT 502, DALLAS, TX 75201-1064
(972) 505-1584
Mailing address
PO BOX 8887, GREENVILLE, TX 75404-8887
(903) 200-1277
(903) 269-3503
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M1829
TX
Other
Enumeration date
01/25/2011
Last updated
10/08/2019
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