MEDICARE: MISS KERRY A SEMBERA PNP

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	163WX0601X	Otorhinolaryngology & Head-Neck Registered Nurse	679627	TX
2	363LP0200X	Pediatric Nurse Practitioner	AP116871	TX

General Provider Information

NPI Number	:	1881673655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KERRY A SEMBERA PNP

Provider Business Mailing Address
First Line	:	6550 FANNIN STREET
Second Line	:	SUITE 2001
City	:	HOUSTON
State	:	TX
Zip	:	77030-2709
Country	:	US
Telephone Number	:	713-796-2001
Fax Number	:	713-796-0720

Provider Business Practice Location Address
First Line	:	6550 FANNIN STREET
Second Line	:	SUITE 2001
City	:	HOUSTON
State	:	TX
Zip	:	77030-2709
Country	:	US
Telephone Number	:	713-796-2001
Fax Number	:	713-796-0720

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

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	08/10/2021

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