MEDICARE: KINGDOM HEALING INSTITUTE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207L00000X	Anesthesiology Physician
2	2083A0300X	Addiction Medicine (Preventive Medicine) Physician
3	2084N0400X	Neurology Physician
4	2084E0001X	Epilepsy Physician

General Provider Information

NPI Number	:	1689364390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINGDOM HEALING INSTITUTE

Provider Business Mailing Address
First Line	:	7434 LOUIS PASTEUR DR STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4539
Country	:	US
Telephone Number	:	210-942-2055
Fax Number	:	210-761-8577

Provider Business Practice Location Address
First Line	:	7434 LOUIS PASTEUR DR STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4539
Country	:	US
Telephone Number	:	210-942-2055
Fax Number	:	210-761-8577

Authorized Official
Title or Position	:	OWNER
Name	:	HUSSEIN B MUSA
Credential	:	MD
Telephone Number	:	210-942-2055

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	05/08/2023

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Directions to “KINGDOM HEALING INSTITUTE ” Practice Location

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