Provider Demographics
NPI:1124677042
Name:LIPSCOMB, KIRK M (MD)
Entity type:Individual
Prefix:DR
First Name:KIRK
Middle Name:M
Last Name:LIPSCOMB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 CANYON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-1503
Mailing Address - Country:US
Mailing Address - Phone:214-543-5986
Mailing Address - Fax:
Practice Address - Street 1:2902 CANYON CREEK DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1503
Practice Address - Country:US
Practice Address - Phone:214-543-5986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1081207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease