Individual
DR. JOHN W KISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Mailing address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A73652
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179170901
—
TX
05
—
179170902
—
TX
01
—
179170903
CSHCN2
TX
01
—
179170904
CSHCN1
TX
01
—
A73652
MEDICAL LICENSE
CA
01
—
P00283002
RRMCARE2
—
01
—
P00283005
RRMCARE
—
Enumeration date
06/09/2005
Last updated
01/12/2015
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