Provider Demographics
NPI:1831212844
Name:KIRK, GUNDA LEE (DO)
Entity type:Individual
Prefix:DR
First Name:GUNDA
Middle Name:LEE
Last Name:KIRK
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2340 E TRINITY MILLS RD STE 250
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-1946
Mailing Address - Country:US
Mailing Address - Phone:855-893-5637
Mailing Address - Fax:817-666-3873
Practice Address - Street 1:750 EUREKA ST STE B
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-6521
Practice Address - Country:US
Practice Address - Phone:855-893-5637
Practice Address - Fax:817-666-3873
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH0523207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752546113OtherEIN