Provider Demographics
NPI:1215469705
Name:PHILIP, KEMLY (MD PHD MBE)
Entity type:Individual
Prefix:
First Name:KEMLY
Middle Name:
Last Name:PHILIP
Suffix:
Gender:F
Credentials:MD PHD MBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 WEST LOOP S STE 1100
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2115
Mailing Address - Country:US
Mailing Address - Phone:134-865-5907
Mailing Address - Fax:713-486-0879
Practice Address - Street 1:5420 WEST LOOP S STE 1100
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2115
Practice Address - Country:US
Practice Address - Phone:713-486-5590
Practice Address - Fax:713-486-0879
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT76912081P2900X, 208VP0000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine