Individual
KEVIN JON SCHWANENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4375 BOOTH CALLOWAY RD STE 505, NORTH RICHLAND HILLS, TX 76180-8359
(817) 805-0300
Mailing address
1328 SAND VERBENA WAY, FORT WORTH, TX 76177-7211
(817) 805-0300
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
103109
TX
2471V0105X
Vascular Sonography Radiologic Technologist
Primary
103109
TX
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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