Provider Demographics
NPI:1285739003
Name:KING, INEZ
Entity type:Individual
Prefix:
First Name:INEZ
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3327 RESEARCH PLZ
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78235-5155
Mailing Address - Country:US
Mailing Address - Phone:210-333-0798
Mailing Address - Fax:210-333-4532
Practice Address - Street 1:8711 VILLAGE DR
Practice Address - Street 2:SUITE 114
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5418
Practice Address - Country:US
Practice Address - Phone:210-333-0798
Practice Address - Fax:210-333-4532
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP111953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily