Provider Demographics
NPI:1578527776
Name:FERRY, KATHRYN BOND (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:BOND
Last Name:FERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16980 DALLAS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1908
Mailing Address - Country:US
Mailing Address - Phone:817-461-3003
Mailing Address - Fax:817-469-6156
Practice Address - Street 1:900 W RANDOL MILL RD
Practice Address - Street 2:SUITE 209
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2562
Practice Address - Country:US
Practice Address - Phone:817-461-3003
Practice Address - Fax:817-469-6156
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH67802085R0202X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136660111Medicaid
TX86050ROtherBCBS#
TX136660109Medicaid
TX136660110Medicaid
TX136660111Medicaid
300138890Medicare PIN
TX86050RMedicare ID - Type Unspecified
TXE14628Medicare UPIN
TX8017B9Medicare PIN
300137223Medicare PIN