Provider Demographics
NPI:1306161112
Name:KINMAN, CASEY LYNN (MD)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:LYNN
Last Name:KINMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 N MACARTHUR BLVD STE 425
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2299
Mailing Address - Country:US
Mailing Address - Phone:817-680-0597
Mailing Address - Fax:
Practice Address - Street 1:2001 N MACARTHUR BLVD STE 425
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2299
Practice Address - Country:US
Practice Address - Phone:469-800-1330
Practice Address - Fax:469-800-1340
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR0890207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery