Provider Demographics
NPI:1134153109
Name:KAMATH, VIDYA (MD)
Entity type:Individual
Prefix:
First Name:VIDYA
Middle Name:
Last Name:KAMATH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:88 BRIGGS ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1271
Mailing Address - Country:US
Mailing Address - Phone:210-921-0902
Mailing Address - Fax:210-923-8220
Practice Address - Street 1:88 BRIGGS ST
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1271
Practice Address - Country:US
Practice Address - Phone:210-921-0902
Practice Address - Fax:210-923-8220
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE86072085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology