Healthcare Provider Details

I. General information

NPI: 1174589378
Provider Name (Legal Business Name): DANNY MICHAEL KOFOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 FLOYD CURL DR
SAN ANTONIO TX
78229-3902
US

IV. Provider business mailing address

8109 FREDERICKSBURG RD PHYSICIAN PRACTICE SERVICES
SAN ANTONIO TX
78229-3311
US

V. Phone/Fax

Practice location:
  • Phone: 210-575-6919
  • Fax: 210-575-4013
Mailing address:
  • Phone: 210-575-6919
  • Fax: 210-575-4013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK8266
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberK8266
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: