Provider Demographics
NPI:1629276753
Name:KAREN G CORNETT MD PA
Entity Type:Organization
Organization Name:KAREN G CORNETT MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:G
Authorized Official - Last Name:CORNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-997-0330
Mailing Address - Street 1:200 W WINDCREST ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4408
Mailing Address - Country:US
Mailing Address - Phone:830-997-0330
Mailing Address - Fax:830-997-7601
Practice Address - Street 1:200 W WINDCREST ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4408
Practice Address - Country:US
Practice Address - Phone:830-997-0330
Practice Address - Fax:830-997-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty