Provider Demographics
NPI:1619736295
Name:RIFFLE, KATIE HELEN (DO)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:HELEN
Last Name:RIFFLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:HELEN
Other - Last Name:PEAVLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 W BEN WHITE BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6903
Mailing Address - Country:US
Mailing Address - Phone:512-816-5646
Mailing Address - Fax:
Practice Address - Street 1:901 W BEN WHITE BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6903
Practice Address - Country:US
Practice Address - Phone:512-816-5646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program