Provider Demographics
NPI:1033285028
Name:KIRKMAN, KERRY (MD)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:KIRKMAN
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 1:21216 NORTHWEST FRWY STE 520
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-0088
Mailing Address - Country:US
Mailing Address - Phone:281-955-7900
Mailing Address - Fax:281-955-0700
Practice Address - Street 1:21216 NORTHWEST FRWY STE 520
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-0088
Practice Address - Country:US
Practice Address - Phone:281-955-7900
Practice Address - Fax:281-955-0700
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7776207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165506001Medicaid
TX8B8306Medicare PIN