Provider Demographics
NPI:1326033424
Name:MUSGROVE, KATHRYN H (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:H
Last Name:MUSGROVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:H
Other - Last Name:MUSGROVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2855 GRAMERCY ST # 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1697
Mailing Address - Country:US
Mailing Address - Phone:713-668-6828
Mailing Address - Fax:
Practice Address - Street 1:2855 GRAMERCY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1635
Practice Address - Country:US
Practice Address - Phone:713-668-6828
Practice Address - Fax:713-668-3823
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8309207WX0110X, 207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138573405Medicaid
TX138573410Medicaid
TX138573405Medicaid
88Z038Medicare PIN
TX88Z038OtherBCBS
TX138573405Medicaid