Individual
MRS. KIMBERLY MARIE SADOSKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-4769
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002130
IA
363AS0400X
Surgical Physician Assistant
MA054904
PA
363AS0400X
Surgical Physician Assistant
Primary
PA10080
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548573447
WELLMARK BC/BS
IA
01
—
183256
HEALTH ALLIANCE
IA
05
—
362678002
—
TX
Enumeration date
07/20/2010
Last updated
04/29/2024
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