# KELLUM PHYSICIAN PARTNERS, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073880092
- **Authorized official:** DANIEL HANSFORD KELLUM JR. M.D. (PRESIDENT)
- **Authorized official phone:** (210) 945-2121

## Contact information

- **Practice address:** 3903 WISEMAN BLVD, SUITE 215, SAN ANTONIO, TX 78251-4401
- **Practice address phone:** (210) 675-6724
- **Practice address fax:** (210) 675-1759
- **Mailing address:** 8870 US HIGHWAY 87 E, SAN ANTONIO, TX 78263-2242
- **Mailing address phone:** (210) 648-0152
- **Mailing address fax:** (210) 649-4170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | J1533 | TX | — |
| 207V00000X | Obstetrics & Gynecology Physician | J0844 | TX | Yes |

## Other

- **Enumeration date:** 11/18/2011
- **Last updated:** 04/07/2015