Organization
KIMBERLY UDELL D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY UDELL D.O. (PHYSICIAN)
(817) 468-1506
Entity
Organization
Contact information
Practice address
3602 MATLOCK RD STE 206, ARLINGTON, TX 76015-3600
(817) 468-1506
(817) 468-1520
Mailing address
3602 MATLOCK RD STE 206, ARLINGTON, TX 76015-3600
(817) 468-1506
(817) 468-1520
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L1225
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165666201
—
TX
01
—
8P5630
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/21/2007
Last updated
01/13/2016
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