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General NPI Number Information
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NPI Number | 1053494674
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Entity Type | Individual
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Provider Name | RODNEY DESMOND KIDD JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 7418 JOHN SMITH SUITE 218
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City | SAN ANTONIO
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State | TX
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Zip | 78229-6020
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Country | US
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Telephone | 210-614-0959
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Fax | 210-614-7522
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Provider Business Mailing Address
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Address Line | 7375 W 52ND AVE STE 210
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City | ARVADA
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State | CO
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Zip | 80002-3748
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Country | US
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Telephone | 303-223-4448
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | CDR.0005235
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | L7452
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License Number State | TX
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