Individual
KIMBERLY ANDREWS BORDELON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2411 FOUNTAIN VIEW DR, STE. 200, HOUSTON, TX 77057-4817
(713) 620-4000
Mailing address
755 N 11TH ST, STE P3600, BEAUMONT, TX 77702-1515
(409) 838-5214
(409) 838-1946
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
781241
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212463801
—
TX
01
—
8144UA
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/03/2009
Last updated
07/25/2019
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