MEDICARE: KC J. WEST MD

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	207Q00000X	Family Medicine Physician	S8407	TX

General Provider Information

NPI Number	:	1316476377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KC J. WEST MD

Provider Business Mailing Address
First Line	:	10350 BANDERA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-5615
Country	:	US
Telephone Number	:	210-450-6530
Fax Number	:	210-450-2140

Provider Business Practice Location Address
First Line	:	10350 BANDERA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-5615
Country	:	US
Telephone Number	:	210-450-6530
Fax Number	:	210-450-2140

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

Provider Enumeration Date	:	06/05/2017
Last Update Date	:	05/19/2022

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Directions to “ KC J. WEST MD” Practice Location

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