Kevin Ceballos
Internal Medicine in Georgetown, TX. Individual provider (NPI-1).
NPI number1114555190
StatusActive
Last updated in NPPESSep 13, 2023
Details
- NPI
- 1114555190
- Entity type
- Individual (NPI-1)
- Name
- Kevin Ceballos
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2020
- Certification date
- Sep 13, 2023
- Last updated
- Sep 13, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | U4166 | TX | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
105 Wildwood Dr Ste 105Georgetown, TX 78633-1344
Phone 786-423-5819
Mailing address
1706 Cedar Bend Dr Unit CAustin, TX 78758-2602
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