Individual
BIRCH KIMBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 W BEN WHITE BLVD, AUSTIN, TX 78704-6903
(512) 447-2211
Mailing address
PO BOX 160951, AUSTIN, TX 78716-0951
(512) 328-0832
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
E2654
TX
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
E2654
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128421804
—
TX
05
—
128421806
—
TX
Enumeration date
05/04/2006
Last updated
05/14/2010
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