Doctor Name: | KENNETH R HART |
NPI Number: | 1003998071 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | F8504 |
Business Practice Address: | 5101 Medical Drive San Antonio, TX - 782294801 |
Business Phone Number: | 2105925349 |
Business Fax Number: | 2105925462 |
Mailing Address: | 2935 Thousand Oaks, Suite 294 SAN ANTONIO |
State: | TX |
Postal Code: | 782473312 |
Phone Number: | 2104941100 |
Fax Number: | 2104941117 |
NPI Enumeration Date: | 10/19/2006 |
NPI Last Update Date: | 07/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | F8504 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |