Stallman, Kenneth John
Stallman, Kenneth John is an individual health care provider with primary practice located at 7909 Fredericksburg Rd Suite #120,130, San Antonio TX 78229-3425. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Stallman, Kenneth John can be contacted via phone (210) 614-4544.Contact Information
Primary practice address
7909 Fredericksburg Rd Suite #120,130
San Antonio TX 78229-3425
Phone: (210) 614-4544
Fax: (210) 582-5522
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Urology | 208800000X | M0931 | Texas |
Profile Details
NPI number | 1871575100 |
---|---|
LBN Legal business name | Stallman, Kenneth John |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 14th, 2005 |
Last updated | Aug 26th, 2009 - about 16 years ago |
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 | 1871575100 | NPPES |
Texas | MEDICAID | 176324502 |
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