Individual
KARL DAVID KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
8535 TOM SLICK, SAN ANTONIO, TX 78229-3367
(210) 616-0300
Mailing address
8535 TOM SLICK, SAN ANTONIO, TX 78229-3367
(210) 616-0300
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
30798
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029503201
—
TX
05
—
040518501
—
TX
Enumeration date
11/03/2006
Last updated
01/07/2020
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