Provider Demographics
NPI:1649565409
Name:TINDALL, KATE C (MD)
Entity Type:Individual
Prefix:DR
First Name:KATE
Middle Name:C
Last Name:TINDALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:MAZZARELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4107 SPICEWOOD SPRINGS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8645
Mailing Address - Country:US
Mailing Address - Phone:123-973-3605
Mailing Address - Fax:512-343-7107
Practice Address - Street 1:4107 SPICEWOOD SPRINGS RD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8645
Practice Address - Country:US
Practice Address - Phone:123-973-3605
Practice Address - Fax:512-343-7107
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0192207RH0002X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX888661OtherMEDICARE
TX3594632-03Medicaid