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General NPI Number Information
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NPI Number | 1598739302
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Entity Type | Individual
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Provider Name | THERESA SUZANNE KENT O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/16/2006
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 9725 DATAPOINT DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-2384
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Country | US
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Telephone | 210-930-8165
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Fax |
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Provider Business Mailing Address
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Address Line | 9725 DATAPOINT DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-2384
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Country | US
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Telephone | 210-930-8165
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OE005031T
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License Number State | PA
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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 | 27OA00363700
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License Number State | NJ
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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 | OP 1421
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 07150T
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License Number State | TX
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