Individual
KIMMY WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 PRESTON RD, PLANO, TX 75093-3569
(972) 439-8378
Mailing address
PO BOX 795352, DALLAS, TX 75379-5352
(972) 439-8378
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
853823728
—
TX
Enumeration date
11/28/2020
Last updated
12/11/2020
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