Basic Information
Provider Information
NPI: 1285927426
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAISER
FirstName: JOHN
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: ATP-CRTS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1332 UPLAND DR
Address2:  
City: HOUSTON
State: TX
PostalCode: 770434719
CountryCode: US
TelephoneNumber: 7134680696
FaxNumber: 7134681517
Practice Location
Address1: 1332 UPLAND DR
Address2:  
City: HOUSTON
State: TX
PostalCode: 770434719
CountryCode: US
TelephoneNumber: 7134680696
FaxNumber: 7134681517
Other Information
ProviderEnumerationDate: 05/20/2011
LastUpdateDate: 05/20/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
247200000X  Y Technologists, Technicians & Other Technical Service ProvidersTechnician, Other 

No ID Information.


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