MEDICARE: KEMD CONSULTING P.A.

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1538639372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEMD CONSULTING P.A.

Provider Business Mailing Address
First Line	:	2300 GREEN OAK DR STE 300
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-2051
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 GREEN OAK DR STE 300
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-2051
Country	:	US
Telephone Number	:	281-359-4111
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KIM ELLIOTT
Credential	:	MD
Telephone Number	:	281-359-4111

Provider Enumeration Date	:	12/04/2018
Last Update Date	:	12/04/2018

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