| Doctor Name: | DR. KENT JARVIS |
| NPI Number: | 1023467867 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M |
| License Number: | T46-2016 |
| Business Practice Address: | 200 Kellington Dr N Apt 11303 Kingwood, TX - 773391567 |
| Business Phone Number: | 8057962560 |
| Business Fax Number: | |
| Mailing Address: | 200 Kellington Dr N, Apt 11303 KINGWOOD |
| State: | TX |
| Postal Code: | 773391567 |
| Phone Number: | 8057962560 |
| Fax Number: | |
| NPI Enumeration Date: | 06/10/2016 |
| NPI Last Update Date: | 06/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | T46-2016 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |