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NPI Code Detail

MEDICARE: DR. ELISE L KIBLER M.D.

MEDICARE: DR. ELISE L KIBLER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianM1184TX

General Provider Information

NPI Number : 1831204031
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELISE L KIBLER M.D.
Provider Business Mailing Address
First Line : 903 W MARTIN ST # MS 49-2
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78207-0903
Country : US
Telephone Number : 201-358-5909
Fax Number : 210-358-5940
Provider Business Practice Location Address
First Line : 919 LOCKE ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78208-2127
Country : US
Telephone Number : 210-644-8700
Fax Number : 210-702-4326
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 12/18/2024

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Directions to “ DR. ELISE L KIBLER M.D.” Practice Location

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