Provider Demographics
NPI:1316959539
Name:KENDRA L. THORN, M.D., P.A.
Entity type:Organization
Organization Name:KENDRA L. THORN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:THORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-632-6857
Mailing Address - Street 1:598 N UNION AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4136
Mailing Address - Country:US
Mailing Address - Phone:830-632-6857
Mailing Address - Fax:830-632-9122
Practice Address - Street 1:598 N UNION AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4136
Practice Address - Country:US
Practice Address - Phone:830-632-6857
Practice Address - Fax:830-632-9122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2009-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7221207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0097PWOtherBCBS
TX168441701Medicaid
TX1039925OtherBPIN
TX00391XMedicare ID - Type Unspecified
TXI18243Medicare UPIN