Individual
KIRBY S HAVERDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 450-9000
(210) 450-4903
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 450-9000
(210) 450-4903
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP140404
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
393923301
—
TX
Enumeration date
01/08/2019
Last updated
11/17/2020
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