Provider Demographics
NPI:1558523696
Name:YAMAKAWA, KATHY PHAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:PHAN
Last Name:YAMAKAWA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:PHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:825 PLANTATION DR
Mailing Address - Street 2:#140
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406
Mailing Address - Country:US
Mailing Address - Phone:713-205-7354
Mailing Address - Fax:
Practice Address - Street 1:825 PLANTATION DR
Practice Address - Street 2:#140
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406
Practice Address - Country:US
Practice Address - Phone:713-205-7354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240171223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice