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Organization
KINGSLEY CLINIC PLLC
Active
Organization
KINGSLEY CLINIC PLLC
Active
Other names
The Kingsley Clinic PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES RALPH KINGSLEY JR. MD (CHIEF EXECUTIVE OFFICER)
(530) 305-7637
Entity
Organization
Contact information
Practice address
14180 DALLAS PKWY STE 620, DALLAS, TX 75254-4363
(530) 305-7637
Mailing address
33471 BILTMORE DR, TEMECULA, CA 92592-1849
(530) 305-7637
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R2380
STATE MEDICAL LICENSE
TX
Enumeration date
06/17/2019
Last updated
01/31/2024
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