Healthcare Provider Details

I. General information

NPI: 1174558159
Provider Name (Legal Business Name): KATHLEEN HANDS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 MADISON OAK DR SUITE 270
SAN ANTONIO TX
78258-3943
US

IV. Provider business mailing address

540 MADISON OAK DR SUITE 270
SAN ANTONIO TX
78258-3943
US

V. Phone/Fax

Practice location:
  • Phone: 210-491-9494
  • Fax: 210-491-9696
Mailing address:
  • Phone: 210-491-9494
  • Fax: 210-491-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberM5210
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: