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NPI Code Detail

MEDICARE: CONNOR KALISKY

MEDICARE: CONNOR KALISKY
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
1183500000XPharmacist71145TX

General Provider Information

NPI Number : 1518542687
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNOR KALISKY
Provider Business Mailing Address
First Line : 20935 US HIGHWAY 281 N
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78258-7587
Country : US
Telephone Number : 210-491-2450
Fax Number :
Provider Business Practice Location Address
First Line : 12125 ALAMO RANCH PKWY
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78253-4334
Country : US
Telephone Number : 210-688-9584
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2021
Last Update Date : 12/15/2022

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Directions to “ CONNOR KALISKY ” Practice Location

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