Provider Demographics
NPI:1891707725
Name:MATTHEWS, KENNETH LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:LEE
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13620 NW MILITARY HWY.
Mailing Address - Street 2:BLDG. 3, SUITE 2
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231
Mailing Address - Country:US
Mailing Address - Phone:210-978-4341
Mailing Address - Fax:210-698-9188
Practice Address - Street 1:13620 NW MILITARY HWY.
Practice Address - Street 2:BLDG. 3, SUITE 2
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231
Practice Address - Country:US
Practice Address - Phone:210-978-4341
Practice Address - Fax:210-698-9188
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2012-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXD71742084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry