Active NPI
Kevin Park, DO
- Family Medicine Physician
- Pearland, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- U9050
- Practice address
- 3203 Broadway St
Pearland, TX 77581-1414 - Phone
- (281) 997-3547
- NPI assigned
- Apr 12, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | U9050 | TX | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | U9050 | TX | Primary |
Addresses
Primary practice location
3203 Broadway St
Pearland, TX 77581-1414
Mailing address
930 Frostwood Dr Ste 2.200
Houston, TX 77024-2450
Phone (713) 338-5502
Other practice location 1
1525 Oak Park Blvd
Lake Charles, LA 70601-8849
Phone (337) 494-2023
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3203 Broadway St
Pearland, TX 77581-1414
Phone (281) 485-8876
Hospital & facility affiliations
- Memorial Hermann Hospital System
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| U9050 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hermann Medical Group | Family Medicine | Current | Accepting new patients |
Locations
1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800
1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781
930 Frostwood Dr
Ste 2200
Houston, TX 77024
909 Frostwood Dr
Ste 1405
Houston, TX 77024
Phone (713) 338-5519
915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222
3203 Broadway St
Ste 100
Pearland, TX 77581
Phone (281) 485-8876
3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876
Interoperability endpoints
- kpark146789@memorialhermann.direct-ci.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Fulshear, TX
- NPI 1003985102
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Houston, TX
- NPI 1730132234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787184000000",
"number": "1548840705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 FROSTWOOD DR STE 2.200",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770242450",
"telephone_number": "713-338-5502",
"fax_number": "713-338-6500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3203 BROADWAY ST",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775811414",
"telephone_number": "281-997-3547"
}
],
"practiceLocations": [
{
"address_1": "1525 Oak Park Blvd",
"address_purpose": "LOCATION",
"city": "Lake Charles",
"state": "LA",
"postal_code": "706018849",
"country_code": "US",
"telephone_number": "337-494-2023",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PARK",
"first_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-12",
"last_updated": "2026-08-20",
"certification_date": "2026-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "U9050",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "U9050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.