Provider Demographics
NPI:1033300637
Name:KENNETH O. ALBERS, M.D., P.A.
Entity Type:Organization
Organization Name:KENNETH O. ALBERS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:OTTO
Authorized Official - Last Name:ALBERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-493-3681
Mailing Address - Street 1:909 DAIRY ASHFORD ST
Mailing Address - Street 2:SUITE 216
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5309
Mailing Address - Country:US
Mailing Address - Phone:281-493-3681
Mailing Address - Fax:281-589-1465
Practice Address - Street 1:909 DAIRY ASHFORD ST
Practice Address - Street 2:SUITE 216
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5309
Practice Address - Country:US
Practice Address - Phone:281-493-3681
Practice Address - Fax:281-589-1465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD4904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00282UOtherMEDICARE GROUP