MEDICARE: DR. CHRISTOPHER RUSSELL KANNADY

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	208800000X	Urology Physician	R9506	TX

General Provider Information

NPI Number	:	1780001966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER RUSSELL KANNADY

Provider Business Mailing Address
First Line	:	PO BOX 58538
Second Line	:
City	:	WEBSTER
State	:	TX
Zip	:	77598-8538
Country	:	US
Telephone Number	:	346-250-5680
Fax Number	:	346-610-9690

Provider Business Practice Location Address
First Line	:	4615 SOUTHWEST FWY STE 1000
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-7108
Country	:	US
Telephone Number	:	346-250-5680
Fax Number	:	346-610-9690

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

Provider Enumeration Date	:	03/25/2014
Last Update Date	:	05/05/2026

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