Individual
KIMBERLY R. POARCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA03154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA03154
PHYSICIAN ASSISTANT LICENSE TEXAS MEDICAL BOARD
TX
Enumeration date
04/09/2009
Last updated
08/02/2011
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