Individual
KATHLEEN A KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6410 FANNIN ST, 500, HOUSTON, TX 77030-3000
(832) 325-7111
(713) 500-5711
Mailing address
PO BOX 301173, DALLAS, TX 75303-1173
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
H1602
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
H1602
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132664705
CSHCN
TX
05
—
132664706
—
TX
01
—
84513Y
BCBS
TX
Enumeration date
06/27/2006
Last updated
08/08/2016
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