MEDICARE: ROBERT KEITH LANDRY MD

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	207P00000X	Emergency Medicine Physician	L8405	TX

General Provider Information

NPI Number	:	1215994397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT KEITH LANDRY MD

Provider Business Mailing Address
First Line	:	2331 CUMBERLAND OAK CT
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77345-2150
Country	:	US
Telephone Number	:	281-360-5736
Fax Number	:	281-929-4153

Provider Business Practice Location Address
First Line	:	2331 CUMBERLAND OAK CT
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77345-2150
Country	:	US
Telephone Number	:	281-360-5736
Fax Number	:	281-929-4153

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	04/23/2008

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