Healthcare Provider Details

I. General information

NPI: 1306028824
Provider Name (Legal Business Name): FRANK C KRETSINGER, D.O., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 10/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 CAMDEN ST SUITE 409
SAN ANTONIO TX
78215-2012
US

IV. Provider business mailing address

311 CAMDEN ST SUITE 409
SAN ANTONIO TX
78215-2012
US

V. Phone/Fax

Practice location:
  • Phone: 210-599-8300
  • Fax: 210-599-8853
Mailing address:
  • Phone: 210-599-8300
  • Fax: 210-599-8391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberF6841
License Number StateTX

VIII. Authorized Official

Name: FRANK C KRETSINGER
Title or Position: OWNER
Credential: D.O.
Phone: 210-599-8300