Healthcare Provider Details

I. General information

NPI: 1841425402
Provider Name (Legal Business Name): KEMKA HEKEREM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2009
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HERMANN PRESSLER DR
HOUSTON TX
77030-3900
US

IV. Provider business mailing address

1200 HERMANN PRESSLER DR
HOUSTON TX
77030-3900
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-9450
  • Fax:
Mailing address:
  • Phone: 713-500-9450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number27018
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP4575
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: