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Organization
KERRVILLE MED EXPRESS
Active
Organization
KERRVILLE MED EXPRESS
Active
Other names
International Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD BRUCE DEBENEDETTO M.D. (PHYSICIAN/MEDICAL DIRECTOR)
(956) 761-4649
Entity
Organization
Contact information
Practice address
2217 PADRE BLVD, SOUTH PADRE ISLAND, TX 78597
(956) 761-4649
(866) 594-1025
Mailing address
2217 PADRE BLVD, SOUTH PADRE ISLAND, TX 78597
(956) 761-4649
(866) 594-1025
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
J9579
TX
207R00000X
Internal Medicine Physician
Primary
J9579
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113326621
—
TX
01
—
8CE910
BCBSTX
TX
Enumeration date
10/22/2009
Last updated
12/13/2013
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