Organization
PEDIATRIC INSTITUTE OF SOUTHWEST TEXAS,P.A.
Active
Other names
Kubena Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KASSIA LOUEVA KUBENA M.D., (OWNER/PHYSICIAN)
(210) 877-9966
Entity
Organization
Contact information
Practice address
5255 PRUE RD, SUITE #105, SAN ANTONIO, TX 78240-1335
(210) 877-9966
(210) 877-1162
Mailing address
5255 PRUE RD, SUITE #105, SAN ANTONIO, TX 78240-1335
(210) 877-9966
(210) 877-1162
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0051LZ
BLUE CROSS ID NUMBER
TX
05
—
169084401
—
TX
Enumeration date
06/19/2006
Last updated
01/12/2010
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