Organization
NEO2TEEN PEDIATRIC CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH ETOKHANA MD (PRESIDENT)
(210) 888-9960
Entity
Organization
Contact information
Practice address
6735 FM 78, SUITE 103, SAN ANTONIO, TX 78244-1367
(210) 888-9960
(210) 888-9422
Mailing address
23723 SUNSET PEAK, SAN ANTONIO, TX 78258-7544
(210) 888-9960
(210) 888-9422
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
P2438
TX
Other
Enumeration date
02/26/2017
Last updated
04/27/2017
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