Healthcare Provider Details

I. General information

NPI: 1881689081
Provider Name (Legal Business Name): KENNETH HIGBY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 FLOYD CURL DR
SAN ANTONIO TX
78229-3931
US

IV. Provider business mailing address

8300 FLOYD CURL DR STE 227
SAN ANTONIO TX
78229-3931
US

V. Phone/Fax

Practice location:
  • Phone: 210-450-9500
  • Fax:
Mailing address:
  • Phone: 210-450-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberH9649
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: