KELLY R. KUNKEL, M.D., P.A. (NPI# 1902227424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902227424 |
| Entity Type | Organization |
| Organization Name | KELLY R. KUNKEL, M.D., P.A. |
| Practice Address |
1830 8th Ave Fort Worth TX 76110-1391 |
| Practice Telephone | 8173355200 |
| Practice Fax Number | 8179230780 |
| Mailing Telephone | 8173355200 |
| Mailing Fax Number | 8179230780 |
| Enumeration Date | 2013-12-31 |
| Last Update Date | 2013-12-31 |
| Authorized Official Name | DR. KELLY RAYMOND KUNKEL (PRESIDENT) |
| Authorized Official Telephone | 8173355200 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 208650122X | TX | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE IDENTIFICATION NUMBER | 0025AA | 01 |
| Street Address |
1830 8TH AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76110-1391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730144502 | Kelly R Kunkel | Plastic Surgery | 1830 8th Ave, Fort Worth, TX 76110-1391 | 2006-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992177240 | Sarah Jones Midwifery | Midwife | 2260 5th Ave, Fort Worth, TX 76110 | 2015-10-27 |
| 1427371814 | Cenikor Foundation | Community/Behavioral Health | 2209 South Main Street, Fort Worth, TX 76110 | 2010-03-12 |
| 1225282320 | Ktv Dental, Pa | Dentist | 2717 8th Ave., Fort Worth, TX 76110 | 2008-11-17 |
| 1821291014 | Michael J Davis | Dentist | 1818 8th Avenue, Fort Worth, TX 76110 | 2007-06-06 |
| 1669513347 | Latoya Cherrell Carter | Counselor | 1814 8th Ave # B201, Fort Worth, TX 76110 | 2007-02-08 |
| 1659446771 | Christina Pey-ru Chou | Marriage & Family Therapist | 1616 Park Place Ave., Fort Worth, TX 76110 | 2006-11-22 |
| 1750461364 | Zera Inc | Home Health | 1050 Forest Park Blvd, Fort Worth, TX 76110 | 2006-10-17 |
| 1144300914 | Tai Anh Huynh | Optometrist | 1405 West Berry St, Fort Worth, TX 76110 | 2006-10-16 |
| 1871510784 | Robert T Keller Md & Assco Pa | Internal Medicine | 2751 Greenoaks Rd, Fort Worth, TX 76110 | 2006-07-16 |
| 1114906633 | The Womens Center of Tarrant County Inc | Clinic/Center | 1723 Hemphill, Fort Worth, TX 76110 | 2006-01-12 |
| Find all providers in zip 76110 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093334039 | Sport Is Religion | Specialist | 8641 Las Vegas Ct Apt 2722, Fort Worth, TX 76116-0044 | 2020-04-09 |
| 1518471986 | Tyrin W Holt | Specialist | 1540 Berckmans Rd, Fort Worth, TX 76120-1500 | 2017-11-21 |
| 1538567151 | Sarah Dimarco | Specialist | 3704 Staghorn Cir N, Fort Worth, TX 76137-6054 | 2014-12-13 |
| 1639581077 | Pre Diabetes Physician Services Inc | Specialist | 1307 8th Ave Ste 502, Fort Worth, TX 76104-4137 | 2014-05-20 |
| 1447661509 | Veronica C Zapata | Specialist | 1113 Nw 25th St, Fort Worth, TX 76164-6904 | 2014-05-12 |
| 1962835439 | Sara Syeda | Specialist | 7250 Hawkins View Dr Ste 410, Fort Worth, TX 76132-3932 | 2013-08-19 |
| 1750624417 | Jennifer C. Brooks, Md Pllc | Specialist | 909 9th Ave Ste 101, Fort Worth, TX 76104-3916 | 2013-04-01 |
| 1063766178 | Richard Eugene Smith | Specialist | 7162 Axis Ct, Fort Worth, TX 76132-3573 | 2012-10-29 |
| 1770831463 | Sharon A Guillory | Specialist | 5441 S Hulen Street, Dona's Wigs, Fort Worth, TX 76132 | 2012-08-28 |
| 1740537281 | Chu Eye Institute, P.a. | Specialist | 3017 W 7th St # 210, Fort Worth, TX 76107-2223 | 2012-08-14 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76110 |
Please comment or provide details below to improve the information on KELLY R. KUNKEL, M.D., P.A..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.