Provider Demographics
NPI:1336491315
Name:K&S HEALTHCARE, LLC
Entity Type:Organization
Organization Name:K&S HEALTHCARE, LLC
Other - Org Name:NORTHEAST PROHEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:KYPUROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-599-4086
Mailing Address - Street 1:7585 KITTY HAWK
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109
Mailing Address - Country:US
Mailing Address - Phone:210-468-2333
Mailing Address - Fax:210-667-4044
Practice Address - Street 1:7585 KITTY HAWK
Practice Address - Street 2:SUITE 201
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109
Practice Address - Country:US
Practice Address - Phone:210-468-2333
Practice Address - Fax:210-667-4044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5312207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI70749Medicare UPIN