Provider Demographics
NPI:1497217046
Name:HALL, KATHERINE OLIVER (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:OLIVER
Last Name:HALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:502 MADISON OAK DR STE 440
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4189
Mailing Address - Country:US
Mailing Address - Phone:210-946-1300
Mailing Address - Fax:210-946-1700
Practice Address - Street 1:502 MADISON OAK DR STE 440
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4189
Practice Address - Country:US
Practice Address - Phone:210-946-1300
Practice Address - Fax:210-946-1700
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU3226207V00000X
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology