Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | K1714 | TX |
NPI | 1114975893 |
---|---|
Provider Name | Dr. Kurt Vonrueden |
First Address | San Antonio, TX 78299-2726 |
Second Address | Lakeway, TX 78738-5621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 21/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E94955 | (02) | TX |