Healthcare Provider Details

I. General information

NPI: 1043252463
Provider Name (Legal Business Name): BRIAN J KEMPTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12717 INTERSTATE 45 N STE 300
WILLIS TX
77318-7035
US

IV. Provider business mailing address

59 DAHLIA RD
HUNTSVILLE TX
77320-0744
US

V. Phone/Fax

Practice location:
  • Phone: 936-228-7598
  • Fax: 936-228-7599
Mailing address:
  • Phone: 936-662-5505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number37474
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberH8170
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: