Provider Demographics
NPI:1649221235
Name:GREENWAY, KATHRYN AUDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:AUDRA
Last Name:GREENWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 PRESTON PARK BLVD STE 2400
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3716
Mailing Address - Country:US
Mailing Address - Phone:972-867-7862
Mailing Address - Fax:972-612-1623
Practice Address - Street 1:1820 PRESTON PARK BLVD STE 2400
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3716
Practice Address - Country:US
Practice Address - Phone:972-867-7862
Practice Address - Fax:972-612-1623
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM47952085R0202X, 2085R0204X
TXBP50020819390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program