Provider Demographics
NPI:1932328457
Name:FREEMAN, KEVIN M (DDS)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:M
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 WASHINGTON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5673
Mailing Address - Country:US
Mailing Address - Phone:713-360-7638
Mailing Address - Fax:713-360-7463
Practice Address - Street 1:4000 WASHINGTON AVE STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5673
Practice Address - Country:US
Practice Address - Phone:713-360-7638
Practice Address - Fax:713-360-7463
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19679122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist