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Individual

ALICIA R W KINCAID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2001 N JEFFERSON AVE STE 203, MOUNT PLEASANT, TX 75455-2310
(903) 434-8880
(903) 434-8881
Mailing address
2001 N JEFFERSON AVE, MOUNT PLEASANT, TX 75455-2338
(903) 434-8044

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2016020856
MO
208600000X
Surgery Physician
Primary
T9426
TX
208600000X
Surgery Physician
TL.0006478
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2016020856
MISSOURI BOARD OF HEALING ARTS
MO
01
TL.0006478
PHYSICIAN TRAINING LICENSE
CO
Enumeration date
06/23/2016
Last updated
04/27/2026
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