Individual
DR. KEVIN PROUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 617-5256
(210) 949-3006
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(708) 710-9314
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Q1479
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Q1479
TX
207RP1001X
Pulmonary Disease Physician
36.095321
OH
207RP1001X
Pulmonary Disease Physician
Primary
Q1479
TX
390200000X
Student in an Organized Health Care Education/Training Program
4301090115
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341591101
—
TX
Enumeration date
07/19/2007
Last updated
02/25/2015
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