Provider Demographics
NPI:1073502563
Name:WALSH, KATRINA H (MD)
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:H
Last Name:WALSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1600 COIT RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6174
Mailing Address - Country:US
Mailing Address - Phone:972-519-1900
Mailing Address - Fax:972-964-5323
Practice Address - Street 1:1600 COIT RD
Practice Address - Street 2:SUITE 402
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6174
Practice Address - Country:US
Practice Address - Phone:972-519-1900
Practice Address - Fax:972-964-5323
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ1422207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH73SMedicare ID - Type Unspecified
TXE95442Medicare UPIN