Provider Demographics
NPI:1437432820
Name:BLANCHETTE, KATHERINE L (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:BLANCHETTE
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 1:7457 HARWIN DR STE 148
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2021
Mailing Address - Country:US
Mailing Address - Phone:713-974-1177
Mailing Address - Fax:713-974-1198
Practice Address - Street 1:7457 HARWIN DR STE 148
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2021
Practice Address - Country:US
Practice Address - Phone:713-974-1177
Practice Address - Fax:713-974-1198
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0188208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB159262Medicare PIN