Provider Demographics
NPI:1114918745
Name:KAUFMANN, JEANNINE STOUT (MD)
Entity Type:Individual
Prefix:DR
First Name:JEANNINE
Middle Name:STOUT
Last Name:KAUFMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7007 BANDERA RD
Mailing Address - Street 2:STE. 19
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1138
Mailing Address - Country:US
Mailing Address - Phone:210-680-6000
Mailing Address - Fax:210-680-9153
Practice Address - Street 1:7007 BANDERA RD
Practice Address - Street 2:STE. 19
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1138
Practice Address - Country:US
Practice Address - Phone:210-680-6000
Practice Address - Fax:210-680-9153
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4444208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1114918745OtherNPI
TX890101OtherBCBS
TX890101OtherBCBS
TXF44388Medicare UPIN