Provider Demographics
NPI:1497749816
Name:MCCREE, KATHI (MD)
Entity Type:Individual
Prefix:
First Name:KATHI
Middle Name:
Last Name:MCCREE
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 1:250 BLOSSOM ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4243
Mailing Address - Country:US
Mailing Address - Phone:281-724-0190
Mailing Address - Fax:281-724-1740
Practice Address - Street 1:250 BLOSSOM ST STE 100
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4243
Practice Address - Country:US
Practice Address - Phone:281-724-0190
Practice Address - Fax:281-724-1740
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8401207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080110918OtherRAILROAD MEDICARE
TX86Z067OtherBCBS
TX4103136OtherAETNA
TX87593ZOtherHMO BLUE
TX045338301Medicaid
TX86Z067Medicare PIN
TX86Z067OtherBCBS