Provider Demographics
NPI:1376030932
Name:DENSON, KENDALL DERAN (N/A)
Entity Type:Individual
Prefix:MR
First Name:KENDALL
Middle Name:DERAN
Last Name:DENSON
Suffix:
Gender:M
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31727 SERRANO BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4330
Mailing Address - Country:US
Mailing Address - Phone:832-819-8249
Mailing Address - Fax:832-460-3030
Practice Address - Street 1:31727 SERRANO BLUFF LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4330
Practice Address - Country:US
Practice Address - Phone:832-819-8249
Practice Address - Fax:832-460-3030
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
AL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies