Pengra, Kimberly R.

Pengra, Kimberly R. is an individual health care provider with primary practice located at 23222 Kingsland Blvd Suite A, Katy TX 77494-3033. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Pengra, Kimberly R. can be contacted via phone (281) 693-0084.

Contact Information

Primary practice address
23222 Kingsland Blvd Suite A Katy TX 77494-3033
Phone: (281) 693-0084
Fax: (281) 693-0093
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X Texas

Profile Details

NPI number 1407164742
LBN Legal business name Pengra, Kimberly R.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2010
Last updated Jan 10th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407164742 NPPES
Texas Other 1407164742 BLUE CROSS BLUE SHIELD

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