Basic Information
Provider Information
NPI: 1972923548
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GEE
FirstName: KRISTIN
MiddleName: MINEI
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MINEI
OtherFirstName: KRISTIN
OtherMiddleName: MARIE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 660599
Address2:  
City: DALLAS
State: TX
PostalCode: 752660599
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5201 HARRY HINES BLVD
Address2: GRADUATE MEDICAL EDUCATION
City: DALLAS
State: TX
PostalCode: 752357708
CountryCode: US
TelephoneNumber: 2145908058
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/22/2014
LastUpdateDate: 05/14/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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