Provider Demographics
NPI:1225034085
Name:KATHLEEN G. HALKA, M.D., P.A.
Entity Type:Organization
Organization Name:KATHLEEN G. HALKA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HALKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-223-9888
Mailing Address - Street 1:8001 MIDCROWN DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-2316
Mailing Address - Country:US
Mailing Address - Phone:210-223-9888
Mailing Address - Fax:210-223-4198
Practice Address - Street 1:8001 MIDCROWN DRIVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218
Practice Address - Country:US
Practice Address - Phone:210-223-9888
Practice Address - Fax:210-223-4198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3491174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080761202Medicaid
TX00547KMedicare ID - Type UnspecifiedMEDICARE-GROUP NUMBER