Provider Demographics
NPI:1174140842
Name:VEGA CARTAGENA, KERMITH SAUL (MD)
Entity type:Individual
Prefix:
First Name:KERMITH
Middle Name:SAUL
Last Name:VEGA CARTAGENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4243 E SOUTHCROSS BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-3750
Mailing Address - Country:US
Mailing Address - Phone:210-304-3500
Mailing Address - Fax:210-337-2909
Practice Address - Street 1:4243 E SOUTHCROSS BLVD STE 205
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3750
Practice Address - Country:US
Practice Address - Phone:210-304-3500
Practice Address - Fax:210-337-2909
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU0868207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine