Provider Demographics
NPI:1316476377
Name:WEST, KC J (MD)
Entity type:Individual
Prefix:
First Name:KC
Middle Name:J
Last Name:WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:10350 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-5615
Mailing Address - Country:US
Mailing Address - Phone:210-450-6530
Mailing Address - Fax:210-450-2140
Practice Address - Street 1:10350 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-5615
Practice Address - Country:US
Practice Address - Phone:210-450-6530
Practice Address - Fax:210-450-2140
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS8407207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program