Individual
DR. KEVIN W NIBLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3430 W WHEATLAND RD POB I STE 119, DALLAS, TX 75237-3447
(972) 283-2244
(972) 283-2246
Mailing address
3430 W WHEATLAND RD, POB I SUITE 119, DALLAS, TX 75237-3446
(972) 283-2244
(972) 283-2246
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
J3706
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105633502
—
TX
05
—
105633503
—
TX
01
—
613557
MEDICARE PTAN
TX
Enumeration date
06/12/2006
Last updated
04/13/2026
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