Provider Demographics
NPI:1194457390
Name:KING, KACHEL (MED)
Entity type:Individual
Prefix:
First Name:KACHEL
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 DUNFORD DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-2414
Mailing Address - Country:US
Mailing Address - Phone:254-314-6782
Mailing Address - Fax:
Practice Address - Street 1:822 DUNFORD DR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-2414
Practice Address - Country:US
Practice Address - Phone:254-314-6782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor