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General NPI Number Information
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NPI Number | 1518311588
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Entity Type | Individual
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Provider Name | WILHELM ANDRES KIENAST MD
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Gender | Male
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Dates
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Enumeration Date | 04/15/2016
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 910 MAJOR SHERMAN LN STE 305
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City | MONTEREY
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State | CA
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Zip | 93940-4644
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Country | US
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Telephone | 813-718-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 13803 LOCKE LN
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City | HOUSTON
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State | TX
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Zip | 77077-5418
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Country | US
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Telephone | 713-449-4431
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | A152058
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License Number State | CA
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