Individual
KENNETH R HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5101 MEDICAL DRIVE, SAN ANTONIO, TX 78229-4801
(210) 592-5349
(210) 592-5462
Mailing address
2935 THOUSAND OAKS, SUITE 294, SAN ANTONIO, TX 78247-3312
(210) 494-1100
(210) 494-1117
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
F8504
TX
2083A0100X
Aerospace Medicine Physician
F8504
TX
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
F8504
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081285101
—
TX
05
—
081285102
—
TX
05
—
132637302
—
TX
Enumeration date
10/19/2006
Last updated
07/16/2015
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