Healthcare Provider Details
I. General information
NPI: 1851559728
Provider Name (Legal Business Name): JEAN A. KNAPPS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/28/2008
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1125 CYPRESS STATION DR STE G-3
HOUSTON TX
77090-3055
US
IV. Provider business mailing address
1125 CYPRESS STATION DR STE G-3
HOUSTON TX
77090-3055
US
V. Phone/Fax
- Phone: 815-831-3002
- Fax:
- Phone: 281-583-1300
- Fax: 281-583-1303
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | Q9176 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | Q9176 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: