Provider Demographics
NPI:1245597756
Name:KITCHEN, JESSICA ASHLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ASHLEY
Last Name:KITCHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ASHLEY
Other - Last Name:BLOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-450-9900
Mailing Address - Fax:
Practice Address - Street 1:11212 HIGHWAY 151
Practice Address - Street 2:STE.100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4498
Practice Address - Country:US
Practice Address - Phone:210-450-9900
Practice Address - Fax:210-450-9901
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3853207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX348605201Medicaid
TX348605202OtherCSHCN
TX422743YK00Medicare PIN