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:
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Health care specialties

SpecialtyCodeLicense #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 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871575100 NPPES
Texas MEDICAID 176324502

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