Provider Demographics
NPI:1558344077
Name:MCDONALD, KATHLEEN R (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:R
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:14140 SOUTHWEST FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3842
Mailing Address - Country:US
Mailing Address - Phone:281-649-7000
Mailing Address - Fax:713-484-6649
Practice Address - Street 1:11914 ASTORIA BLVD
Practice Address - Street 2:#360
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6064
Practice Address - Country:US
Practice Address - Phone:281-484-3981
Practice Address - Fax:281-481-0182
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2022-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK0125207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB166198OtherMEDICARE - GROUP#
TX101528102Medicaid
TXTXB166198OtherMEDICARE - GROUP#