Provider Demographics
NPI:1609819838
Name:FIKKERT, CHIMENE WILLIS (DO)
Entity type:Individual
Prefix:
First Name:CHIMENE
Middle Name:WILLIS
Last Name:FIKKERT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9003 AIRPORT FWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7770
Mailing Address - Country:US
Mailing Address - Phone:817-514-5200
Mailing Address - Fax:817-514-5210
Practice Address - Street 1:811 INTERSTATE 20 W
Practice Address - Street 2:SUITE 100
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5870
Practice Address - Country:US
Practice Address - Phone:817-557-5437
Practice Address - Fax:817-375-0980
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-11-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL4371208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150775801Medicaid
TX150775801Medicaid