KMG NURSE PRACTITIONER SERVICES LLC NPI 1053853663

NPI Information

  • NPI: 1053853663
  • Provider Name: KMG NURSE PRACTITIONER SERVICES LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Address: 7926 MADDIE LN
    SAN ANTONIO, TX
    ZIP 78255
  • Phone: (210) 827-1218

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NPI Details

KMG NURSE PRACTITIONER SERVICES LLC is a family nurse practitioner in San Antonio, TX. KMG NURSE PRACTITIONER SERVICES LLC NPI is 1053853663. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7926 MADDIE LN
SAN ANTONIO, TX
ZIP 78255-524
Phone: (210) 827-1218
Fax: (210) 475-3366

The provider's authorized official is Kara Goodspeed .
The authorized official title is Owner and has the following contact phone number (210) 827-1218.

The enumeration date for this NPI number is 11/14/2016 and was last updated on 11/14/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyAP115987TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1185831801MEDICAIDTEXAS
28J6489MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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