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General NPI Number Information
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NPI Number | 1629233127
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Entity Type | Individual
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Provider Name | KENNETH OSHIOKHAYAMHE ETOKHANA M.D
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Gender | Male
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 6735 FM 78 STE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78244-1368
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Country | US
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Telephone | 210-888-9960
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Fax | 210-888-9422
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Provider Business Mailing Address
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Address Line | 6735 FM 78 STE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78244-1368
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Country | US
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Telephone | 210-888-9960
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Fax | 210-888-9422
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | P2438
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License Number State | TX
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