Provider Demographics
NPI:1740267525
Name:BELL, GREGORY KITTREDGE (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:KITTREDGE
Last Name:BELL
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 2380
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78298-2380
Mailing Address - Country:US
Mailing Address - Phone:512-531-5200
Mailing Address - Fax:512-865-4068
Practice Address - Street 1:2000 SCENIC DR STE G002
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7726
Practice Address - Country:US
Practice Address - Phone:512-531-5200
Practice Address - Fax:512-865-4068
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK13572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX44970408Medicaid
TXG32327Medicare UPIN
TX44970408Medicaid
TX272202YN56Medicare PIN