Provider Demographics
NPI:1366540932
Name:SUMPTER, KRISTI KAYE (DO)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:KAYE
Last Name:SUMPTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12827 JONES RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4605
Mailing Address - Country:US
Mailing Address - Phone:281-894-9990
Mailing Address - Fax:281-894-9993
Practice Address - Street 1:12827 JONES RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4605
Practice Address - Country:US
Practice Address - Phone:281-894-9990
Practice Address - Fax:281-894-9993
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0630208600000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX040033502Medicaid
8H4710OtherBCBS
8H4710OtherBCBS
TX040033502Medicaid