MEDICARE: KEVIN DESAI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1073387627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN DESAI

Provider Business Mailing Address
First Line	:	5655 W 34TH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-6509
Country	:	US
Telephone Number	:	731-991-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	5655 W 34TH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-6509
Country	:	US
Telephone Number	:	731-991-3500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2023
Last Update Date	:	11/14/2023

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Directions to “ KEVIN DESAI ” Practice Location

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