MEDICARE: KMD PARTNERSHIP LLC

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	261Q00000X	Clinic/Center		TX

General Provider Information

NPI Number	:	1528495678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KMD PARTNERSHIP LLC

Provider Business Mailing Address
First Line	:	13115 N BELLAIRE ESTATES DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-2393
Country	:	US
Telephone Number	:	832-782-3964
Fax Number	:

Provider Business Practice Location Address
First Line	:	13115 N BELLAIRE ESTATES DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-2393
Country	:	US
Telephone Number	:	832-782-3964
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEVIN DAVIES
Credential	:
Telephone Number	:	832-782-3964

Provider Enumeration Date	:	10/03/2013
Last Update Date	:	10/25/2013

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Directions to “KMD PARTNERSHIP LLC ” Practice Location

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