Provider Demographics
NPI:1023113404
Name:BELL, KRISTIN C (MD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:C
Last Name:BELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11521 FM 620 N
Mailing Address - Street 2:SUITE C800
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-1139
Mailing Address - Country:US
Mailing Address - Phone:512-219-0670
Mailing Address - Fax:
Practice Address - Street 1:11521 FM 620 N
Practice Address - Street 2:SUITE C800
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726-1139
Practice Address - Country:US
Practice Address - Phone:512-219-0670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0548207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP0548OtherSTATE LICENSE
TX303207001Medicaid
TXTXB158530Medicare PIN