Kollaus, Kennard Lee
Kollaus, Kennard Lee is an sole proprietor health care provider with primary practice located at 2525 N Veterans Blvd , Eagle Pass TX 78852-3302. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kollaus, Kennard Lee can be contacted via phone (830) 773-5358.Contact Information
Primary practice address
2525 N Veterans Blvd
Eagle Pass TX 78852-3302
Phone: (830) 773-5358
Fax: (830) 773-0258
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | G8222 | Texas |
Profile Details
| NPI number | 1528147063 |
|---|---|
| LBN Legal business name | Kollaus, Kennard Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 3rd, 2006 |
| Last updated | Nov 9th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528147063 | NPPES |
| Texas | Other | 1277162-10 | MEDICAID-TX PROVIDER IDENTIFIER (TPI) # (TYPE: PERFORMING PROVIDER) |
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