MEDICARE: KATHLEEN FRANCES ARCHER M.D.

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	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	G2587	TX
2	207W00000X	Ophthalmology Physician	G2587	TX

General Provider Information

NPI Number	:	1295720167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN FRANCES ARCHER M.D.

Provider Business Mailing Address
First Line	:	909 DAIRY ASHFORD RD STE 114
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-5306
Country	:	US
Telephone Number	:	713-984-9810
Fax Number	:	713-984-9855

Provider Business Practice Location Address
First Line	:	909 DAIRY ASHFORD RD STE 114
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-5306
Country	:	US
Telephone Number	:	713-984-9810
Fax Number	:	713-984-9855

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	01/28/2021

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