Individual
DR. BOBBY JOE KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6811 AUSTIN CENTER BLVD, #300, AUSTIN, TX 78731-3146
(512) 346-8888
(512) 344-0312
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
E6115
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097806603
—
TX
05
—
097806604
—
TX
01
—
CZ49
BCBS
TX
05
—
CZ49
—
TX
Enumeration date
08/31/2006
Last updated
03/02/2012
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