Healthcare Provider Details

I. General information

NPI: 1861459729
Provider Name (Legal Business Name): JOHN PAUL KUPFERSCHMID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N SANTA ROSA
SAN ANTONIO TX
78207-3108
US

IV. Provider business mailing address

4410 MEDICAL DR SUITE 540
SAN ANTONIO TX
78229-6306
US

V. Phone/Fax

Practice location:
  • Phone: 210-704-4100
  • Fax:
Mailing address:
  • Phone: 210-575-6240
  • Fax: 210-575-6280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberK9322
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberK9322
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME167753
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: