Individual
DR. KENT CHARLES JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
11703 HUEBNER RD, SUITE 109, SAN ANTONIO, TX 78230-1201
(210) 764-7575
(210) 764-7576
Mailing address
11703 HUEBNER RD, SUITE 109, SAN ANTONIO, TX 78230-1201
(210) 764-7575
(210) 764-7576
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3951TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
270049
MEDICARE PTAN
—
Enumeration date
11/08/2006
Last updated
06/06/2013
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