Provider Demographics
NPI:1679714612
Name:KADAVIL FNP & ASSOCIATES P.C.
Entity type:Organization
Organization Name:KADAVIL FNP & ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TESSY
Authorized Official - Middle Name:T
Authorized Official - Last Name:KADAVIL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:210-274-5264
Mailing Address - Street 1:7713 HIGHLAND PARK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-5127
Mailing Address - Country:US
Mailing Address - Phone:210-274-5264
Mailing Address - Fax:210-699-1732
Practice Address - Street 1:7713 HIGHLAND PARK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-5127
Practice Address - Country:US
Practice Address - Phone:210-274-5264
Practice Address - Fax:210-699-1732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-22
Last Update Date:2009-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty