Kevin Jon Schwanenberg

Primary specialty

Vascular Sonography Radiologic TechnologistTaxonomy code 2471V0105X

License

103109 Issued in TX

Practice address

4375 Booth Calloway Rd Ste 505
North Richland Hills, TX 76180-8359

Phone

(817) 805-0300

NPI assigned

Jan 28, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1740744317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 SAND VERBENA WAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761777211",
            "telephone_number": "817-805-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 BOOTH CALLOWAY RD STE 505",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761808359",
            "telephone_number": "817-805-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWANENBERG",
        "first_name": "KEVIN",
        "middle_name": "JON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-28",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "TX",
            "license": "103109",
            "primary": false
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "TX",
            "license": "103109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaliah Sami, LCSW
• Debbie Gisela Sanchez, SLPA
• Jasmin Sanchez
• Sarah Talbott, OD PLLC
• McKenzie Schuring
• Arlene Schwartz, O.D.
• Mark I Schwartz, O.D.
• Jon Schweitzer, D.C
• Trace Schwerman, PT
• Scott a. Wenger, M.D., PLLC

• Radiologic Technologist in North Richland Hills, TX
• Providers in North Richland Hills, TX by specialty
• Radiologic Technologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.