Provider Demographics
NPI:1154309573
Name:WELD, KYLE JONES (MD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:JONES
Last Name:WELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7909 FREDERICKSBURG RD.
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3400
Mailing Address - Country:US
Mailing Address - Phone:210-731-2050
Mailing Address - Fax:210-679-3724
Practice Address - Street 1:7909 FREDERICKSBURG RD.
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3400
Practice Address - Country:US
Practice Address - Phone:210-731-2050
Practice Address - Fax:210-679-3724
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN29056208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX346095801Medicaid
TX386254YNQMOtherMEDICARE
TXVAD000Medicare UPIN