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General NPI Number Information
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NPI Number | 1073827978
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Entity Type | Organization
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Legal Business Name | KISH KOMIE, LP
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 02/02/2012
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Provider Practice Location Address
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Address Line | 9180 KATY FWY SUITE 150
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City | HOUSTON
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State | TX
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Zip | 77055-7454
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Country | US
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Telephone | 713-465-0911
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Fax |
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Provider Business Mailing Address
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Address Line | 9180 KATY FWY SUITE 150
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City | HOUSTON
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State | TX
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Zip | 77055-7454
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Country | US
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Telephone | 713-465-0911
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JACK JENSEN
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Credential | MD
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Telephone | 713-984-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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