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Individual

KENNETH J MAVERICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4775 HAMILTON WOLFE RD, BUILDING 2, SAN ANTONIO, TX 78229-3463
(210) 614-3600
(210) 614-3604
Mailing address
4775 HAMILTON WOLFE RD, BUILDING 2, SAN ANTONIO, TX 78229-3463
(210) 614-3600
(210) 614-3604

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M0814
TX

Other

Enumeration date
01/23/2007
Last updated
07/09/2007
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