Provider Demographics
NPI:1871973453
Name:OUSLEY, KIA (MD)
Entity type:Individual
Prefix:
First Name:KIA
Middle Name:
Last Name:OUSLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 E HWY 290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-406-9596
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:1910 QUAKER AVE STE 101
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407
Practice Address - Country:US
Practice Address - Phone:806-725-4440
Practice Address - Fax:806-725-4441
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10053886207Q00000X
TXR0469207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine