Individual
AVIAN D KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2900 MCKINNON ST # 502, DALLAS, TX 75201
(972) 505-1584
(844) 582-3627
Mailing address
2900 MCKINNON ST # 502, DALLAS, TX 75201-1064
(972) 505-1584
(844) 582-3627
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M1829
TX
208M00000X
Hospitalist Physician
M1829
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175473101
—
TX
05
—
175473103
—
TX
05
—
175473104
—
TX
05
—
175473105
—
TX
01
—
8BR081
BCBS
TX
01
—
8S3699
BCBS
TX
01
—
8X0055
BCBS
TX
Enumeration date
09/26/2006
Last updated
08/12/2019
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