Provider Demographics
NPI:1629602883
Name:GREGORY, KATHRYN GEREN
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:GEREN
Last Name:GREGORY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 LEGEND MILL CT
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1360
Mailing Address - Country:US
Mailing Address - Phone:936-697-0123
Mailing Address - Fax:
Practice Address - Street 1:38 LEGEND MILL CT
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-1360
Practice Address - Country:US
Practice Address - Phone:936-697-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator