Healthcare Provider Details

I. General information

NPI: 1255654489
Provider Name (Legal Business Name): KDUNN AND ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 WIRT RD SUITE E2
HOUSTON TX
77055-4904
US

IV. Provider business mailing address

2504 ELMEN ST
HOUSTON TX
77019-6712
US

V. Phone/Fax

Practice location:
  • Phone: 713-464-1051
  • Fax:
Mailing address:
  • Phone: 713-981-6125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberJ0756
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208U00000X
TaxonomyClinical Pharmacology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberJ0756
License Number StateTX

VIII. Authorized Official

Name: DR. KIM DUNN
Title or Position: PRESIDENT
Credential: MD, PH.D.
Phone: 713-981-6125