Individual
DR. CHARLENE DEKONENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
333 N SANTA ROSA, SAN ANTONIO, TX 78207-3108
(210) 704-3030
Mailing address
3901 RAINBOW BLVD, M/S #2005, KANSAS CITY, KS 66160-8500
(913) 588-6124
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
V3277
TX
2086S0120X
Pediatric Surgery Physician
Primary
V3277
TX
Other
Enumeration date
04/06/2015
Last updated
08/19/2024
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