Provider Demographics
NPI:1316123953
Name:MULTANI, KIRANPREET KAUR (DO)
Entity type:Individual
Prefix:DR
First Name:KIRANPREET
Middle Name:KAUR
Last Name:MULTANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8711 VILLAGE DR STE 114
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5419
Mailing Address - Country:US
Mailing Address - Phone:210-496-2669
Mailing Address - Fax:210-202-3790
Practice Address - Street 1:525 OAK CENTRE DR STE 350
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258
Practice Address - Country:US
Practice Address - Phone:210-496-2669
Practice Address - Fax:210-202-3790
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8110207Q00000X
MI5101016432207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036122188-1Medicaid
IL09015685OtherBCBS OF IL
IL779491OtherMEDICARE PTAN
IL779491OtherMEDICARE PTAN