Provider Demographics
NPI:1386713519
Name:VOGTSBERGER, KENNETH NORMAN (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:NORMAN
Last Name:VOGTSBERGER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:6711 S NEW BRAUNFELS AVE STE 500
Mailing Address - Street 2:MEDICAL SERVICES DEPARTMENT, BLDG 667E
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-3004
Mailing Address - Country:US
Mailing Address - Phone:210-532-9610
Mailing Address - Fax:210-531-3795
Practice Address - Street 1:6711 S NEW BRAUNFELS AVE STE 500
Practice Address - Street 2:MEDICAL SERVICES DEPARTMENT, BLDG 667E
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3004
Practice Address - Country:US
Practice Address - Phone:210-532-9610
Practice Address - Fax:210-531-3795
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE-47392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB-27359Medicare UPIN
TX22640Medicare ID - Type Unspecified