Provider Demographics
NPI:1962598482
Name:KIRBY, ARTHUR G II (MS,MDIV)
Entity type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:G
Last Name:KIRBY
Suffix:II
Gender:M
Credentials:MS,MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8207 CALLAGHAN ROAD
Mailing Address - Street 2:SUITE 425
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230
Mailing Address - Country:US
Mailing Address - Phone:210-326-4068
Mailing Address - Fax:210-692-1168
Practice Address - Street 1:8207 CALLAGHAN ROAD
Practice Address - Street 2:SUITE 425
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230
Practice Address - Country:US
Practice Address - Phone:210-326-4068
Practice Address - Fax:210-692-1168
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC11789101YM0800X, 101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5001LCOtherBLUE CROSS BLUE SHIELD