Basic Information
Provider Information
NPI: 1255778767
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KINARD
FirstName: SARAH
MiddleName: B.
NamePrefix:  
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3750 COMMERCIAL AVE
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782213117
CountryCode: US
TelephoneNumber: 2103343700
FaxNumber: 2102717208
Practice Location
Address1: 256 S KRUEGER AVE
Address2:  
City: NEW BRAUNFELS
State: TX
PostalCode: 781306941
CountryCode: US
TelephoneNumber: 8306200299
FaxNumber: 8306200297
Other Information
ProviderEnumerationDate: 05/24/2013
LastUpdateDate: 05/24/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X28886TXY Dental ProvidersDentist 

No ID Information.


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