Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 1954 | TX |
NPI | 1023269925 |
---|---|
Provider Name | Kris A Ford |
First Address | San Antonio, TX 78216-5832 |
Second Address | San Antonio, TX 78211-3758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2008 |
Last Update Date | 11/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8BT932 | BCBS (01) |