Provider Demographics
NPI:1114992807
Name:KUESTERMANN, SVEN (MD)
Entity Type:Individual
Prefix:
First Name:SVEN
Middle Name:
Last Name:KUESTERMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18410 RUSTLING RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-3635
Mailing Address - Country:US
Mailing Address - Phone:210-494-1778
Mailing Address - Fax:
Practice Address - Street 1:9901 IH 10 W
Practice Address - Street 2:SUITE 400
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2246
Practice Address - Country:US
Practice Address - Phone:210-892-0228
Practice Address - Fax:210-694-0035
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH460192085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B8032Medicare ID - Type Unspecified
TXH46019Medicare UPIN