Doctor Name: | MR. KEVIN M. PFISTER |
NPI Number: | 1144669193 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA |
License Number: | |
Business Practice Address: | 10301 Gateway Blvd W El Paso, TX - 799257701 |
Business Phone Number: | 9155959000 |
Business Fax Number: | |
Mailing Address: | 11200 Sean Haggerty Dr Apt 2114, EL PASO |
State: | TX |
Postal Code: | 799343394 |
Phone Number: | 8326215946 |
Fax Number: | |
NPI Enumeration Date: | 06/21/2013 |
NPI Last Update Date: | 06/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |