1477758787 NPI number — DR. DAVID SCOTT KENT MD

Table of content: DR. DAVID SCOTT KENT MD (NPI 1477758787)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477758787 NPI number — DR. DAVID SCOTT KENT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KENT
Provider First Name:
DAVID
Provider Middle Name:
SCOTT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477758787
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 58538
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEBSTER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77598-8538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-932-1822
Provider Business Mailing Address Fax Number:
713-932-1679

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23501 CINCO RANCH BLVD STE G205
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KATY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77494-3286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
346-253-2254
Provider Business Practice Location Address Fax Number:
346-273-6462
Provider Enumeration Date:
06/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  M7326 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8W4999 . This is a "BLUECROSS BLUESHIELD OF TX" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P00695488 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 189700102 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 189700104 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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