Provider Demographics
NPI:1518007863
Name:KAITNER, MARK ALAN (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ALAN
Last Name:KAITNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16170 JONES MALTSBERGER RD
Mailing Address - Street 2:STE 106
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3202
Mailing Address - Country:US
Mailing Address - Phone:210-485-1844
Mailing Address - Fax:210-399-2731
Practice Address - Street 1:16607 BLANCO RD
Practice Address - Street 2:SUITE 303
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1913
Practice Address - Country:US
Practice Address - Phone:210-485-1844
Practice Address - Fax:210-399-2730
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2021-09-20
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Provider Licenses
StateLicense IDTaxonomies
TXN0871207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L11898Medicare UPIN
TX265032ZPGZMedicare PIN