Provider Demographics
NPI:1144593245
Name:HOWERTON, KATHLEEN GAYLE (COTA)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:GAYLE
Last Name:HOWERTON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:GAYLE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21301 KUYKENDAHL RD STE B
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2614
Mailing Address - Country:US
Mailing Address - Phone:713-805-8917
Mailing Address - Fax:
Practice Address - Street 1:21301 KUYKENDAHL RD STE B
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-2614
Practice Address - Country:US
Practice Address - Phone:281-379-2102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211054172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker