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General NPI Number Information
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NPI Number | 1104057363
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Entity Type | Individual
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Provider Name | MARC DAVID KESSNER O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 4331 THOUSAND OAKS DR
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City | SAN ANTONIO
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State | TX
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Zip | 78217-2101
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Country | US
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Telephone | 210-826-1720
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Fax | 210-826-1792
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Provider Business Mailing Address
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Address Line | 1441 CONTOUR DR APT 831
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City | SAN ANTONIO
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State | TX
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Zip | 78212-1267
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Country | US
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Telephone | 210-826-1720
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Fax | 210-826-1792
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7818-T
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618001882
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7818TG
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License Number State | TX
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