Provider Demographics
NPI:1639881048
Name:KATY DIABETES AND ENDOCRINOLOGY PLLC
Entity Type:Organization
Organization Name:KATY DIABETES AND ENDOCRINOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:VIVIENNE
Authorized Official - Last Name:LEYCO-POLICARPIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-437-6531
Mailing Address - Street 1:26077 NELSON WAY STE 1201
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6698
Mailing Address - Country:US
Mailing Address - Phone:832-437-6531
Mailing Address - Fax:832-437-6548
Practice Address - Street 1:26077 NELSON WAY STE 1201
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6698
Practice Address - Country:US
Practice Address - Phone:832-437-6531
Practice Address - Fax:832-437-6548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty