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General NPI Number Information
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NPI Number | 1538909163
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Entity Type | Individual
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Provider Name | TORI NICOLE KINAMON MD
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Gender | Female
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | SAN ANTONIO MILITARY MEDICAL CENTER 3551 ROGER BROOKE DRIVE
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City | JBSA, FT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 210-916-1284
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Fax | 210-916-7323
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Provider Business Mailing Address
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Address Line | 1100 WILFORD HALL LOOP BLDG 455459
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City | JBSA LACKLAND
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State | TX
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Zip | 78236-5638
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Country | US
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Telephone |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101288927
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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Taxonomy #3
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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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