Individual
KIMBERLY WILT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 THAT WAY ST, LAKE JACKSON, TX 77566-4188
(979) 549-6347
Mailing address
1155 DAIRY ASHFORD RD STE 560, HOUSTON, TX 77079-3035
(713) 799-2200
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
177268
TX
Other
Enumeration date
05/11/2020
Last updated
05/11/2020
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