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Organization
KPS CARDIOVASCULAR SURGERY PA
Active
Organization
KPS CARDIOVASCULAR SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLIFFORD KITTEN M.D. (PRESIDENT)
(281) 583-4000
Entity
Organization
Contact information
Practice address
118 SHENANDOAH DR, SUITE A, SHENANDOAH, TX 77381-1204
(281) 583-4000
(281) 580-5079
Mailing address
118 SHENANDOAH DR, SUITE A, SHENANDOAH, TX 77381-1204
(281) 583-4000
(281) 580-5079
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095021403
—
TX
Enumeration date
09/28/2006
Last updated
09/29/2015
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