Individual
DR. KENNETH PODELL
Active
Individual
DR. KENNETH PODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
36351
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310963902
—
TX
01
—
7509104450
BLUE CROSS-BLUE CROSS
—
01
—
KP010294
COMMERCIAL-COMMERCIAL NUMBER
—
05
—
PHD888810
—
MI
Enumeration date
01/08/2007
Last updated
03/16/2025
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