Provider Demographics
NPI:1356303374
Name:HELD, KRISTIN STORY (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:STORY
Last Name:HELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E SONTERRA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4054
Mailing Address - Country:US
Mailing Address - Phone:210-490-6759
Mailing Address - Fax:210-490-6507
Practice Address - Street 1:325 E SONTERRA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4054
Practice Address - Country:US
Practice Address - Phone:210-490-6759
Practice Address - Fax:210-490-6507
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0853174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPOOON62D8Medicaid
TXPOOON62D8Medicaid
TXE04502Medicare UPIN