Provider Demographics
NPI:1972600583
Name:CHESSHIR, KIMBERLY A (MD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:CHESSHIR
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 1:6750 N MACARTHUR BLVD
Mailing Address - Street 2:STE 206
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2875
Mailing Address - Country:US
Mailing Address - Phone:972-406-9911
Mailing Address - Fax:972-406-9930
Practice Address - Street 1:6750 N MACARTHUR BLVD
Practice Address - Street 2:STE 206
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2875
Practice Address - Country:US
Practice Address - Phone:972-406-9911
Practice Address - Fax:972-406-9930
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5485207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1972600583OtherNPI
TX1942526991OtherNPI-GROUP
TXTXB128091OtherMEDICARE GROUP NUMBER
TXTXB128092Medicare PIN
TXH29770Medicare UPIN