Individual provider Active NPI

Kendall Renee Roehl, MD

  • Plastic and Reconstructive Surgery Physician
  • Webster, TX
National Provider Identifier
1528262102
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
M8291 Issued in TX
Practice address
26 Professional Park Dr
Webster, TX 77598-4127
Phone
(713) 609-9335
NPI assigned
Jun 14, 2007
Last updated
Mar 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X BP2-0019769 TX
Plastic and Reconstructive Surgery Physician 2086S0122X M8291 TX Primary

Addresses

Primary practice location

26 Professional Park Dr
Webster, TX 77598-4127

Mailing address

26 Professional Park Dr
Webster, TX 77598-4127
Phone (713) 609-9335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081230000328 TX Practitioner - Plastic and Reconstructive Surgery 0648332650 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP2-0019769TXMDPlastic and Reconstructive Surgery Physician
M8291TXMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Jul 6, 2010 Accepting new patients
Memorial Plastic Surgery, LLLP CurrentSince Mar 1, 2016 Accepting new patients
Scott & White Clinic CurrentSince Jul 6, 2010 Accepting new patients
Utmb Faculty Group Practice CurrentSince Jun 22, 2009 Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

8731 Katy Fwy
Ste 500
Houston, TX 77024
Phone (713) 633-4411

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1528262102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 PROFESSIONAL PARK DR",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984127",
            "telephone_number": "713-609-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 PROFESSIONAL PARK DR",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984127",
            "telephone_number": "713-609-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEHL",
        "first_name": "KENDALL",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "BP2-0019769",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "M8291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.