Provider Demographics
NPI:1518337005
Name:KB SURGICAL ASSISTANTS, PLLC
Entity Type:Organization
Organization Name:KB SURGICAL ASSISTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KAITNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-347-7767
Mailing Address - Street 1:16170 JONES MALTSBERGER RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3202
Mailing Address - Country:US
Mailing Address - Phone:210-998-5527
Mailing Address - Fax:210-579-8601
Practice Address - Street 1:16170 JONES MALTSBERGER RD STE 106
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3202
Practice Address - Country:US
Practice Address - Phone:210-289-0996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty