# KERRY DEAN VANCE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1699737692
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2012025753 | MO | Yes |
| 207Q00000X | Family Medicine Physician | 7596 | AK | — |
| 207Q00000X | Family Medicine Physician | H5367 | TX | — |

## Other

- **Enumeration date:** 04/05/2006
- **Last updated:** 04/08/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1314130-08 | — | TX |
| 01 | — | 1314130-09 | CSHCN | TX |
| 05 | — | 131413010 | — | TX |
| 01 | — | 8CD653 | BC/BS | TX |
| 01 | — | 8U1465 | BLUE SHIELD | TX |