Organization
JOHN W KRISTENSEN, M. D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA RAMIREZ (INSURANCE CLERK)
(956) 689-5506
Entity
Organization
Contact information
Practice address
165 S 6TH ST, RAYMONDVILLE, TX 78580-3521
(956) 689-5506
(956) 689-1988
Mailing address
165 S 6TH ST, RAYMONDVILLE, TX 78580-3521
(956) 689-5506
(956) 689-1988
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
G2414
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00SH91
BCBS OF TX
TX
01
—
110005062
RAILROAD MEDICARE
TX
05
—
121472802
—
TX
Enumeration date
09/12/2008
Last updated
10/29/2008
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