Organization
MEDICAL SURGICAL SPECIALIST OF KERRVILLE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HUGHES (OFFICER MANAGER)
(830) 896-5005
Entity
Organization
Contact information
Practice address
1001 WATER ST STE D-200, KERRVILLE, TX 78028-3566
(830) 896-5005
(830) 896-4747
Mailing address
1001 WATER ST STE D-200, KERRVILLE, TX 78028-3566
(830) 896-5005
(830) 896-4747
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
G2979
TX
174400000X
Specialist
Primary
H9895
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097289502
—
TX
05
—
136809405
—
TX
Enumeration date
11/21/2013
Last updated
03/06/2020
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