Provider Demographics
NPI:1972506426
Name:GAFFNEY, KEVIN CLIFFORD (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:CLIFFORD
Last Name:GAFFNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9180 PINECROFT DR STE 500
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3883
Mailing Address - Country:US
Mailing Address - Phone:713-897-5900
Mailing Address - Fax:713-897-2545
Practice Address - Street 1:9180 PINECROFT DR STE 500
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3883
Practice Address - Country:US
Practice Address - Phone:713-897-5900
Practice Address - Fax:713-897-2545
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL49442084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157258802Medicaid
TX00659NOtherMDCR GRP PTAN - MONTGOMERY COUNTY
TX153449706OtherMDCD GRP TPI - MONTGOMERY COUNTY
TX0035TDOtherBCBSTX GRP PROVIDER RECORD NUMBER
TX00659NOtherMDCR GRP PTAN - MONTGOMERY COUNTY
TX0035TDOtherBCBSTX GRP PROVIDER RECORD NUMBER