Basic Information
| Provider Information | |||||||||
| NPI: | 1194929497 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIBEL | ||||||||
| FirstName: | LIANE | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5655 WEST SPRING CREEK PKWY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725999600 | ||||||||
| FaxNumber: | 9725999696 | ||||||||
| Practice Location | |||||||||
| Address1: | 5655 WEST SPRING CREEK PKWY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725999600 | ||||||||
| FaxNumber: | 9725999696 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 01063166A | IN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | M8083 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 194205401 | 05 | TX | MEDICAID | 194205402 | 05 | TX | MEDICAID |