Individual provider Active NPI

Kristen Kautzman, O.D.

  • Corneal and Contact Management Optometrist
  • San Antonio, TX
National Provider Identifier
1124274972
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
6309T Issued in TX
Practice address
12919 San Pedro
San Antonio, TX 78216-2048
Phone
(210) 490-0134
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 6309T TX Primary

Addresses

Primary practice location

12919 San Pedro
San Antonio, TX 78216-2048

Mailing address

13003 Vidorra Vista Dr
San Antonio, TX 78216-7763
Phone (210) 490-0134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6309TTXMDCorneal and Contact Management Optometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1124274972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13003 VIDORRA VISTA DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167763",
            "telephone_number": "210-490-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12919 SAN PEDRO",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162048",
            "telephone_number": "210-490-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUTZMAN",
        "first_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "6309T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.