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Individual

KEMBA BAKER BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
15655 CYPRESSWOODS MEDICAL DR, SUITE 100, HOUSTON, TX 77014-1471
(713) 442-1700
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M6032
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
186601401
TX
05
186601402
TX
Enumeration date
05/17/2007
Last updated
12/09/2016
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