Healthcare Provider Details

I. General information

NPI: 1164594271
Provider Name (Legal Business Name): ROBERT HARRIS KEMP O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 FREEPORT ST
HOUSTON TX
77015-2310
US

IV. Provider business mailing address

311 FREEPORT ST
HOUSTON TX
77015-2310
US

V. Phone/Fax

Practice location:
  • Phone: 713-451-3330
  • Fax: 713-451-3454
Mailing address:
  • Phone: 713-451-3330
  • Fax: 713-451-3454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4397
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: