Provider Demographics
NPI:1225575889
Name:KEVIN R. HIGGINS DPM PA
Entity Type:Organization
Organization Name:KEVIN R. HIGGINS DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:210-657-2644
Mailing Address - Street 1:8811 VILLAGE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5415
Mailing Address - Country:US
Mailing Address - Phone:210-657-2644
Mailing Address - Fax:210-657-6834
Practice Address - Street 1:8811 VILLAGE DR STE 150
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5415
Practice Address - Country:US
Practice Address - Phone:210-657-2644
Practice Address - Fax:210-657-6834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0980213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty