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General NPI Number Information
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NPI Number | 1710962972
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Entity Type | Individual
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Provider Name | KEVIN BRUCE HORTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 1202 E SONTERRA BLVD STE 401
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4091
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Country | US
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Telephone | 210-542-1212
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Fax | 210-469-3794
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Provider Business Mailing Address
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Address Line | 1202 E SONTERRA BLVD STE 401
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4091
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Country | US
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Telephone | 210-469-3790
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Fax | 210-469-3794
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G3478
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License Number State | TX
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