Provider Demographics
NPI:1386537231
Name:KIRKWOOD PRIMARY CARE AND WELLNESS PLLC
Entity type:Organization
Organization Name:KIRKWOOD PRIMARY CARE AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:832-454-2728
Mailing Address - Street 1:11003 RESOURCE PKWY STE 106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6142
Mailing Address - Country:US
Mailing Address - Phone:832-454-2728
Mailing Address - Fax:
Practice Address - Street 1:11003 RESOURCE PKWY STE 106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6142
Practice Address - Country:US
Practice Address - Phone:832-454-2728
Practice Address - Fax:855-538-0813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1750541991OtherNPI