=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386833150
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KEMP & PETERSON ODS PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/17/2007
-----------------------------------------------------
Last Update Date | 01/29/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 311 FREEPORT ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77015-2310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-451-3330
-----------------------------------------------------
Fax | 713-451-3454
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 311 FREEPORT ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77015-2310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-451-3330
-----------------------------------------------------
Fax | 713-451-3454
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PARTNERSHIP
-----------------------------------------------------
Name | DR. ROBERT H. KEMP
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 713-451-3330
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 4397
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------