Provider Demographics
NPI:1316968902
Name:BASS, KIMBERLEY ANNE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLEY
Middle Name:ANNE
Last Name:BASS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:KIMBERLEY
Other - Middle Name:ANNE
Other - Last Name:ZAMBITO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1401 ST JOSEPH PKWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8301
Mailing Address - Country:US
Mailing Address - Phone:713-756-5663
Mailing Address - Fax:
Practice Address - Street 1:1919 LA BRANCH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8321
Practice Address - Country:US
Practice Address - Phone:713-756-5663
Practice Address - Fax:713-756-4518
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist