Individual
KERRY L KIKUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 MEDICAL CENTER BLVD, WEBSTER, TX 77598-4220
(281) 338-3110
(281) 338-3352
Mailing address
2921 SEA CHANNEL DR, SEABROOK, TX 77586-1641
(281) 326-7626
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
L8766
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167957301
—
TX
05
—
167957302
—
TX
01
—
8G6286
BCBSTX PROV NO
TX
Enumeration date
12/21/2005
Last updated
12/09/2009
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