Healthcare Provider Details

I. General information

NPI: 1477551901
Provider Name (Legal Business Name): ARTURO R LLANOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 WATER ST SUITE 103
KERRVILLE TX
78028-5200
US

IV. Provider business mailing address

PO BOX 294569
KERRVILLE TX
78029-4569
US

V. Phone/Fax

Practice location:
  • Phone: 803-895-3733
  • Fax:
Mailing address:
  • Phone: 830-895-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH4495
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: