Provider Demographics
NPI:1043921695
Name:APOLINAR, KATHRYN ALLI
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ALLI
Last Name:APOLINAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 28TH AVE N
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-4181
Mailing Address - Country:US
Mailing Address - Phone:409-692-3699
Mailing Address - Fax:
Practice Address - Street 1:6807 EMMETT F LOWRY EXPY # 105
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2546
Practice Address - Country:US
Practice Address - Phone:409-229-4280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician