Individual
DR. KATHERINE MARIE IVEY-VACKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
(210) 916-3334
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
26179
NE
2086S0102X
Surgical Critical Care Physician
T2184
TX
2086S0127X
Trauma Surgery Physician
Primary
T2184
TX
Other
Enumeration date
06/17/2009
Last updated
05/03/2024
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