Individual
DR. KENNETH JOHN BOGENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 580-6586
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(818) 669-0403
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
208600000X
Surgery Physician
MD19764
HI
2086S0129X
Vascular Surgery Physician
A176442
CA
2086S0129X
Vascular Surgery Physician
Primary
V6877
TX
Other
Enumeration date
06/08/2016
Last updated
10/28/2025
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