MEDICARE: CLAUDIA R KYPUROS PH.D. LCSW

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	1041C0700X	Clinical Social Worker	39447	TX

General Provider Information

NPI Number	:	1467990184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA R KYPUROS PH.D. LCSW

Provider Business Mailing Address
First Line	:	4201 MEDICAL DR
Second Line	:	330
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-5656
Country	:	US
Telephone Number	:	210-614-4990
Fax Number	:	210-614-4991

Provider Business Practice Location Address
First Line	:	4201 MEDICAL DR
Second Line	:	330
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-5656
Country	:	US
Telephone Number	:	210-614-4990
Fax Number	:	210-614-4991

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

Provider Enumeration Date	:	02/01/2017
Last Update Date	:	02/01/2017

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