Provider Demographics
NPI:1518311588
Name:KIENAST, WILHELM ANDRES (MD)
Entity Type:Individual
Prefix:DR
First Name:WILHELM
Middle Name:ANDRES
Last Name:KIENAST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13803 LOCKE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5418
Mailing Address - Country:US
Mailing Address - Phone:713-449-4431
Mailing Address - Fax:
Practice Address - Street 1:910 MAJOR SHERMAN LN STE 305
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4644
Practice Address - Country:US
Practice Address - Phone:813-718-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-15
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA1520582086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program