Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1462 | TX |
Y | 222Z00000X | Podiatrist | 1462 | TX |
N | 224P00000X | Prosthetist | 1462 | TX |
NPI | 1134489982 |
---|---|
Provider Name | Mrs. Kimberlee Pfaff |
First Address | San Antonio, TX 78229-4537 |
Second Address | San Antonio, TX 78229-4537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2012 |
Last Update Date | 04/12/2014 |