Provider Demographics
NPI:1578745774
Name:PAPPAS, KERRY MARIE (NP-C)
Entity Type:Individual
Prefix:MS
First Name:KERRY
Middle Name:MARIE
Last Name:PAPPAS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13414 MEDICAL COMPLEX DR
Mailing Address - Street 2:STE 6
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-6470
Mailing Address - Country:US
Mailing Address - Phone:281-516-0212
Mailing Address - Fax:281-255-3320
Practice Address - Street 1:13414 MEDICAL COMPLEX DR
Practice Address - Street 2:STE 6
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6470
Practice Address - Country:US
Practice Address - Phone:281-516-0212
Practice Address - Fax:281-255-3320
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXA1007346207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA1007346OtherSTATE
TX00BM56Medicare UPIN