Provider Demographics
NPI:1427035823
Name:HEGE, KATHERINE KAE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:KAE
Last Name:HEGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:6606 LBJ FWY STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0819207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX132666202Medicaid
TX132666210Medicaid
TX83785KOtherBCBS
TX132666204Medicaid
TX132666209Medicaid
TX132666205Medicaid
TX050064822OtherRAILROAD
TX132666207Medicaid
TX132666208Medicaid
G32177Medicare UPIN
TX132666210Medicaid
TX132666207Medicaid
TX132666204Medicaid
TX132666202Medicaid
TXTXB110541Medicare PIN