Provider Demographics
NPI:1861604779
Name:AHNFELDT, KARI (DO)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:AHNFELDT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8061 ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-4705
Mailing Address - Country:US
Mailing Address - Phone:915-859-7545
Mailing Address - Fax:915-859-9862
Practice Address - Street 1:10780 PEBBLE HILLS BLVD STE G1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-2039
Practice Address - Country:US
Practice Address - Phone:915-773-0606
Practice Address - Fax:915-591-0726
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1780761452OtherCENTRO SAN VICENTE-SAN ELI NPI
TX130880104Medicaid
TX130880105Medicaid
TX1831267079OtherCENTRO SAN VICENTE GROUP NPI
TX130880104Medicaid
TX451901Medicare PIN
TX1831267079OtherCENTRO SAN VICENTE GROUP NPI