Provider Demographics
NPI:1760183404
Name:BULVERDE BREASTFRIENDS
Entity Type:Organization
Organization Name:BULVERDE BREASTFRIENDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KILGORE
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:210-378-2636
Mailing Address - Street 1:449 SALZ WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-1542
Mailing Address - Country:US
Mailing Address - Phone:210-378-2636
Mailing Address - Fax:
Practice Address - Street 1:449 SALZ WAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-1542
Practice Address - Country:US
Practice Address - Phone:210-378-2636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty