Individual
PAUL A KENNEDY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4916 OVERTON PLZ, FORT WORTH, TX 76109-4415
(817) 334-0530
(817) 877-0350
Mailing address
1101 PAW PRINT, LEANDER, TX 78641-3649
(512) 800-3212
(512) 986-7311
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
7932
HI
207L00000X
Anesthesiology Physician
Primary
H6336
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07349001
—
HI
01
—
95513
HMSA
HI
Enumeration date
08/13/2006
Last updated
12/12/2012
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