Provider Demographics
NPI:1073152930
Name:KENNY, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:KENNY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7733 LOUIS PASTEUR DR APT 128
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3437
Mailing Address - Country:US
Mailing Address - Phone:713-855-2664
Mailing Address - Fax:
Practice Address - Street 1:7733 LOUIS PASTEUR DR APT 128
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3437
Practice Address - Country:US
Practice Address - Phone:713-855-2664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-24
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program