Provider Demographics
NPI:1396971206
Name:ROY, KEVIN MATTHEW (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:MATTHEW
Last Name:ROY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7606 HERNDON PL
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2793
Mailing Address - Country:US
Mailing Address - Phone:347-525-5361
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN STREET, WT6-006
Practice Address - Street 2:TEXAS CHILDREN'S HOSPITAL, PEDIATRICS INTENSIVE CARE
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:832-826-6240
Practice Address - Fax:832-825-6229
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN32792080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L17026Medicaid