Individual
KIMBERSON TANCO
Active
Individual
KIMBERSON TANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
P2379
TX
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
P2379
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300763501
—
TX
01
—
8DH125
BCBS
TX
Enumeration date
03/28/2012
Last updated
10/10/2012
Update your record
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