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General NPI Number Information
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NPI Number | 1295795698
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Entity Type | Individual
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Provider Name | PAUL RICHARD KENWORTHY MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 100 MEDICAL CENTER PKWY STE 600
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City | HUNTSVILLE
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State | TX
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Zip | 77340-4965
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Country | US
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Telephone | 936-435-9200
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Fax | 936-435-9262
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Provider Business Mailing Address
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Address Line | 2255 E MOSSY OAKS RD STE 500
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City | SPRING
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State | TX
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Zip | 77389-1813
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Country | US
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Telephone | 281-440-5300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | K0087
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License Number State | TX
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