Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | R3692 | TX |
Y | 207VG0400X | Gynecologist | R3692 | TX |
NPI | 1689665846 |
---|---|
Provider Name | Dr. Scott M Kambiss |
First Address | San Antonio, TX 78248-1347 |
Second Address | San Antonio, TX 78229-4404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2103117 | (05) | MA |
I30587 | (02) | MA |