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General NPI Number Information
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NPI Number | 1396714697
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Entity Type | Individual
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Provider Name | TESSA A KINCADE M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 10/03/2012
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Provider Practice Location Address
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Address Line | 104 S FLAGSTONE PATH CIR
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City | THE WOODLANDS
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State | TX
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Zip | 77381-6620
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Country | US
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Telephone | 225-329-8976
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Fax |
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Provider Business Mailing Address
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Address Line | 104 S FLAGSTONE PATH CIR
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City | THE WOODLANDS
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State | TX
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Zip | 77381-6620
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Country | US
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Telephone | 225-329-8976
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 21573
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD202513
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License Number State | LA
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