Provider Demographics
NPI:1629066881
Name:KENNY, JULIA P (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:P
Last Name:KENNY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:16424 REVELLO DR
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-5159
Mailing Address - Country:US
Mailing Address - Phone:210-247-5186
Mailing Address - Fax:210-352-4880
Practice Address - Street 1:607 E SONTERRA BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4282
Practice Address - Country:US
Practice Address - Phone:210-247-5186
Practice Address - Fax:210-352-4880
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK2226207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030879303Medicaid
8B5419Medicare ID - Type Unspecified
TX030879303Medicaid