Individual
KIMBERLY LYNNE MENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4945 WILLIAMS DR, GEORGETOWN, TX 78633-2008
(512) 819-0500
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8620T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
351131301
—
TX
05
—
351131302
—
TX
Enumeration date
12/06/2006
Last updated
03/04/2021
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