MEDICARE: INEZ KING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP111953	TX

General Provider Information

NPI Number	:	1285739003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INEZ KING

Provider Business Mailing Address
First Line	:	3327 RESEARCH PLZ
Second Line	:	SUITE 303
City	:	SAN ANTONIO
State	:	TX
Zip	:	78235-5155
Country	:	US
Telephone Number	:	210-333-0798
Fax Number	:	210-333-4532

Provider Business Practice Location Address
First Line	:	8711 VILLAGE DR
Second Line	:	SUITE 114
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-5418
Country	:	US
Telephone Number	:	210-333-0798
Fax Number	:	210-333-4532

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	06/02/2016

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Directions to “ INEZ KING ” Practice Location

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