Provider Demographics
NPI:1548796345
Name:BIEDERMAN, KATHLEEN TENNYS (NP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:TENNYS
Last Name:BIEDERMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4613 BEE CAVES RD
Mailing Address - Street 2:STE 105
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5206
Mailing Address - Country:US
Mailing Address - Phone:512-892-0490
Mailing Address - Fax:512-892-0589
Practice Address - Street 1:5252 HOLLISTER ST
Practice Address - Street 2:SUITE #201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6214
Practice Address - Country:US
Practice Address - Phone:346-410-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133863363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care