| Doctor Name: | DR. KIMBERLY SUSAN STUMP |
| NPI Number: | 1063619518 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | RT1676 |
| Business Practice Address: | 4945 Williams Dr Georgetown, TX - 786332008 |
| Business Phone Number: | 5128190500 |
| Business Fax Number: | |
| Mailing Address: | Po Box 847408, DALLAS |
| State: | TX |
| Postal Code: | 752847408 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/28/2007 |
| NPI Last Update Date: | 03/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | RT1676 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NH |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |