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NPI Code Detail

MEDICARE: NATHAN KUNNEMANN

MEDICARE: NATHAN KUNNEMANN
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
1183500000XPharmacist51672TX

General Provider Information

NPI Number : 1912253352
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN KUNNEMANN
Provider Business Mailing Address
First Line : 22832 US HIGHWAY 281 N
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78258-7430
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 22832 US HIGHWAY 281 N
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78258-7430
Country : US
Telephone Number : 210-679-2368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2012
Last Update Date : 08/02/2012

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Directions to “ NATHAN KUNNEMANN ” Practice Location

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