Individual
KHIDJA SEYMOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5288 TRAIL LAKE DR STE 13, FORT WORTH, TX 76133-1939
(817) 917-6181
Mailing address
2915 JONAH DR APT 118, FORT WORTH, TX 76108-5937
(817) 917-6181
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
KK307596
CA
207NS0135X
Procedural Dermatology Physician
Primary
KK37596
CA
Other
Enumeration date
01/10/2018
Last updated
06/16/2018
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