Provider Demographics
NPI:1558593251
Name:KAUFMAN, KATIE MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:MARIE
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4613 BEE CAVE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5203
Mailing Address - Country:US
Mailing Address - Phone:512-347-0700
Mailing Address - Fax:512-347-0702
Practice Address - Street 1:4613 BEE CAVE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5203
Practice Address - Country:US
Practice Address - Phone:512-347-0700
Practice Address - Fax:512-347-0702
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7463152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist