Provider Demographics
NPI:1295720167
Name:ARCHER, KATHLEEN FRANCES (MD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:FRANCES
Last Name:ARCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 DAIRY ASHFORD RD STE 114
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5306
Mailing Address - Country:US
Mailing Address - Phone:713-984-9810
Mailing Address - Fax:713-984-9855
Practice Address - Street 1:909 DAIRY ASHFORD RD STE 114
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5306
Practice Address - Country:US
Practice Address - Phone:713-984-9810
Practice Address - Fax:713-984-9855
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2587207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B20947Medicare UPIN
TX8A6253Medicare PIN