Provider Demographics
NPI:1740401934
Name:IRA J. KASPER M.D., P.A.
Entity Type:Organization
Organization Name:IRA J. KASPER M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KASPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-667-9100
Mailing Address - Street 1:5300 N BRAESWOOD BLVD
Mailing Address - Street 2:SUITE 318
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-3307
Mailing Address - Country:US
Mailing Address - Phone:713-667-9100
Mailing Address - Fax:713-667-9133
Practice Address - Street 1:7500 BEECHNUT ST
Practice Address - Street 2:STE 380
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4335
Practice Address - Country:US
Practice Address - Phone:713-667-9100
Practice Address - Fax:713-667-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5944305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB23849Medicare UPIN
TX00BV83Medicare ID - Type Unspecified