Provider Demographics
NPI:1295782142
Name:KLAUS, DUANE (MD)
Entity type:Individual
Prefix:DR
First Name:DUANE
Middle Name:
Last Name:KLAUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 240098
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-0098
Mailing Address - Country:US
Mailing Address - Phone:210-621-0640
Mailing Address - Fax:210-621-2386
Practice Address - Street 1:4402 VANCE JACKSON RD
Practice Address - Street 2:#220
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-5336
Practice Address - Country:US
Practice Address - Phone:210-477-2409
Practice Address - Fax:210-477-0376
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXHO526207L00000X
TXH0526207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131404907Medicaid
TX131404907Medicaid